%0 Journal Article
%T External Validation of Predictors of Mortality in Polytrauma Patients.
%A Becker ER
%A Price AD
%A Barth J
%A Hong S
%A Chowdhry V
%A Starr AJ
%A Sagi HC
%A Park C
%A Goodman MD
%J J Surg Res
%V 301
%N 0
%D 2024 Aug 1
%M 39094520
%F 2.417
%R 10.1016/j.jss.2024.07.024
%X <B>BACKGROUND: </B>The Parkland Trauma Index of Mortality (PTIM) is an integrated, machine learning 72-h mortality prediction model that automatically extracts and analyzes demographic, laboratory, and physiological data in polytrauma patients. We hypothesized that this validated model would perform equally as well at another level 1 trauma center.<BR><B>METHODS: </B>A retrospective cohort study was performed including ∼5000 adult level 1 trauma activation patients from January 2022 to September 2023. Demographics, physiologic and laboratory values were collected. First, a test set of models using PTIM clinical variables (CVs) was used as external validation, named PTIM+. Then, multiple novel mortality prediction models were developed considering all CVs designated as the Cincinnati Trauma Index of Mortality (CTIM). The statistical performance of the models was then compared.<BR><B>RESULTS: </B>PTIM CVs were found to have similar predictive performance within the PTIM + external validation model. The highest correlating CVs used in CTIM overlapped considerably with those of the PTIM, and performance was comparable between models. Specifically, for prediction of mortality within 48 h (CTIM versus PTIM): positive prediction value was 35.6% versus 32.5%, negative prediction value was 99.6% versus 99.3%, sensitivity was 81.0% versus 82.5%, specificity was 97.3% versus 93.6%, and area under the curve was 0.98 versus 0.94.<BR><B>CONCLUSIONS: </B>This external cohort study suggests that the variables initially identified via PTIM retain their predictive ability and are accessible in a different level 1 trauma center. This work shows that a trauma center may be able to operationalize an effective predictive model without undertaking a repeated time and resource intensive process of full variable selection.