What do prehospital trauma scores predict besides mortality?

BACKGROUND Little information is available concerning the ability of prehospital triage scores to predict endpoints other than mortality. METHODS We evaluated two cohorts (a national cohort of 1,360 patients during 2002 and a single center cohort of 1,003 patients in 2003-2005) of trauma patients receiving care from a prehospital mobile intensive care unit (ICU). We tested the ability of prehospital triage scores (MGAP, Revised Trauma Score [RTS], and triage RTS [T-RTS]) to predict a severe injury, the need for a prolonged ICU period, the occurrence of massive hemorrhage, and the need for emergency procedures, and compared them with a reference score (Trauma-Related Injury Severity Score [TRISS]). The areas under the receiver operating characteristic (AUC(ROC)) curves were measured. RESULTS The MGAP, RTS, and T-RTS scores were able to predict an Injury Severity Score >15 (AUC(ROC): 0.75, 0.75, and 0.74, respectively), the need for a stay in ICU >2 days or death (AUC(ROC) of 0.85, 0.83, and 0.83, respectively), and the massive hemorrhage (AUC(ROC): 0.70, 0.72, and 0.73, respectively). In contrast, MGAP, RTS, T-RTS, and TRISS scores were not predictors of the need of an emergency procedure (AUC(ROC): 0.53, 0.51, and 0.52, respectively). Four independent predictors of emergency procedure were noted: penetrating trauma, intravenous colloid administration >750 mL, systolic arterial blood pressure <100 mm Hg, and heart rate >100 bpm. CONCLUSION Prehospital triage scores were predictors of Injury Severity Score >15, prolonged ICU stay, and massive hemorrhage but not of emergency procedure requirement.