Performance evaluation and validation of the Animal Trauma Triage score and modified Glasgow Coma Scale in injured cats: A Veterinary Committee on Trauma registry study.
feline
illness severity score
mortality predictor
Journal
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)
ISSN: 1476-4431
Titre abrégé: J Vet Emerg Crit Care (San Antonio)
Pays: United States
ID NLM: 101152804
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
29
06
2017
accepted:
12
08
2017
pubmed:
31
8
2019
medline:
18
12
2019
entrez:
31
8
2019
Statut:
ppublish
Résumé
To examine the Animal Trauma Triage (ATT) and modified Glasgow Coma Scale (mGCS) scores as predictors of mortality in injured cats. Observational cohort study conducted September 2013 to March 2015. Nine Level I and II veterinary trauma centers. Consecutive sample of 711 cats reported on the Veterinary Committee on Trauma (VetCOT) case registry. None. We compared the predictive power (area under receiver operating characteristic curve; AUROC) and calibration of the ATT and mGCS scores to their components. Overall mortality risk was 16.5% (95% confidence interval [CI], 13.9-19.4). Head trauma prevalence was 11.8% (n = 84). The ATT score showed a linear relationship with mortality risk. Discriminatory performance of the ATT score was excellent (AUROC = 0.87 [95% CI, 0.84-0.90]). Each ATT score increase of 1 point was associated with an increase in mortality odds of 1.78 (95% CI, 1.61-1.97, P < 0.001). The eye/muscle/integument category of the ATT showed the lowest discrimination (AUROC = 0.60). When this component, skeletal, and cardiac components were omitted from score calculation, there was no loss in discriminatory capacity compared with the full score (AUROC = 0.86 vs 0.87, respectively, P = 0.66). The mGCS showed fair performance overall for prediction of mortality, but the point estimate of performance improved when restricted to head trauma patients (AUROC = 0.75, 95% CI, 0.70-0.80 vs AUROC = 0.80, 95% CI, 0.70-0.90). The motor component of the mGCS showed the best predictive performance (AUROC = 0.71); however, the full score performed better than the motor component alone (P = 0.004). When assessment was restricted to patients with head injury (n = 84), there was no difference in performance between the ATT and mGCS scores (AUROC = 0.82 vs 0.80, P = 0.67). On a large, multicenter dataset of feline trauma patients, the ATT score showed excellent discrimination and calibration for predicting mortality; however, an abbreviated score calculated from the perfusion, respiratory, and neurologic categories showed equivalent performance.
Identifiants
pubmed: 31468694
doi: 10.1111/vec.12885
pmc: PMC6739155
mid: NIHMS1046105
doi:
Types de publication
Journal Article
Observational Study, Veterinary
Validation Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
478-483Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR000114
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002494
Pays : United States
Organisme : NIH HHS
Pays : United States
Informations de copyright
© Veterinary Emergency and Critical Care Society 2019.
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