Trauma-Angio score as a predictor of urgent angioembolization for blunt trauma: development and validation using independent cohorts.

Abstract

This research aimed to establish a scoring system for selecting candidates for urgent angioembolization (AE). Patients with blunt trauma were retrospectively identified in a nationwide trauma registry. Patients aged ≥ 15years with a systolic blood pressure of ≥90mmHg were included. These individuals were then categorized into development and validation cohorts based on the date of admission. Next, an eight-point scaled system was developed using odds ratios obtained from the multivariate analysis of patients' clinical factors on their arrival at the hospital, with the implementation of urgent AE as a dependent variable. The development cohort and validation cohort included 158,192 and 116,941 patients, respectively, and 3296 (2.1%) patients in the development cohort and 2,550 (2.2%) patients in the validation cohort underwent urgent AE. The frequency of transfusion within 24h after arrival and the Injury Severity Score were similar between the two cohorts (16,867 [10.7%] vs. 11,222 [9.6%] and 10 [9-18] vs. 10 [9-17], respectively). The number of patients who were discharged and hospital-free days were comparable between the two cohorts (139,436 [94.4%] vs. 106,107 [95.6%] and 72 [53-84] vs. 73 [57-84] days, respectively). The probabilities and the observed rates of urgent AE increased proportionally from 2% at a score of ≤ 3 to almost 15% at a score of ≥ 7. In terms of predictive factors, no significant interaction was noted. The Trauma-Angio scoring system can be used as a trigger to suggest the possibility of urgent AE. 20090087, 31st July 2009.