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. 2022 Mar 1;6(4):26–40. doi: 10.29045/14784726.2022.03.6.4.26

Table 3.

Relationship between identified pre-hospital variables and major trauma.

Author, year Measure of association used Outcome Prognostic factor(s) Results (95% CI, where reported)
Scheetz et al., 2007 Sensitivity and specificity ISS ≥ 16 > 1 occupants injured Sensitivity, 74.4% (68.0–80.1);
Specificity, 45.6% (44.3–47.0)
Occupant not independently mobile Sensitivity, 93.8% (88.9–97.0);
Specificity, 71.4% (70.2–72.5)
Alcohol involved Sensitivity, 14.0% (9.3–20.0);
Specificity, 95.9% (95.3–96.3)
Drug use Sensitivity, 8.6% (4.6–14.2);
Specificity, 98.5% (98.2–98.8)
Restraints not used Sensitivity, 35.3% (28.7–42.4);
Specificity, 92.2% (91.6–92.8)
Head-on collision Sensitivity, 17.4% (12.5–23.1);
Specificity, 97.9% (97.5–98.2)
Significant variables in CART analysis ISS ≥ 16 > 1 occupants injured
Occupant not independently mobile
Alcohol involved
Drug use
Restraints not used
Head-on collision		 Occupant not mobile, head-on collision, other injured occupants selected as significant prognostic factors
Caterino et al., 2011 Sensitivity and specificity Mortality GCS ≤ 14 Sensitivity, 59.2% (56.1–62.3);
Specificity, 85.1% (84.6–85.7)
GCS ≤ 13 Sensitivity, 50.7% (47.5–53.9);
Specificity, 93.8% (93.4–94.2)
Neurosurgical intervention GCS ≤ 14 Sensitivity, 49.7% (42.6–56.9);
Specificity, 82.8% (82.2–83.4)
GCS ≤ 13 Sensitivity, 42.7% (35.7–49.9);
Specificity, 91.5% (91.0–91.9)
Intubation GCS ≤ 14 Sensitivity, 66.3% (62.2–70.1);
Specificity, 84.2% (83.6–84.8)
GCS ≤ 13 Sensitivity, 57.5% (53.3–61.6);
Specificity, 92.9% (92.5–93.3)
Newgard et al., 2012 Adjusted odds ratio ISS ≥ 16 EMS provider judgement Adjusted OR=1.23 (1.03–1.47)
Newgard et al., 2014 Univariable association ISS ≥ 16 GCS score
SBP
Respiratory rate
Shock index
Heart rate		 Significant non-linear relationships p < 0.001:

  • GCS score – monotonically decreasing

  • SBP, heart rate, shock index – u-shaped

  • Respiratory rate – j-shaped
Multi-variable association ISS ≥ 16 GCS score
SBP
Respiratory rate
Shock index
Heart rate		 Significant non-linear relationships, p < 0.001:

  • GCS score, SBP, respiratory rate, shock index

Non-significant relationship, p=0.48:

  • Heart rate
Importance of variables in CART analysis ISS ≥ 16 GCS score
SBP
Respiratory rate
Shock index
Heart rate		 Important variables and optimal cut-off point:

  • GCS score ≤ 14

  • Respiratory rate < 10 or > 24 breaths per minute

  • SBP < 110 or > 200 mmHg

  • Shock index > 1.0

  • Heart rate ranked low in variable importance
Davidson et al., 2014 Sensitivity and specificity ISS ≥ 16 Intrusion > 12 inches occupant site Sensitivity, 47.8% (42.4–53.3);
Specificity, 62.7% (59.2–66.3)
Intrusion > 18 inches anywhere Sensitivity, 10.9% (9.3–12.4);
Specificity, 66.5% (63.2–69.9)
Death in vehicle Sensitivity, 28.5% (24.9–32.1);
Specificity, 86.1% (84.6–87.6)
Steering wheel collapse Sensitivity, 0.8% (0.59–1.1);
Specificity, 99.6% (99.4–99.7)
Roof crush > 12 inches occupant site Sensitivity, 5.1% (4.1–6.0);
Specificity, 75.6% (72.5–78.8)
Roof crush > 18 inches anywhere Sensitivity, 1.8% (1.2–2.4);
Specificity, 90.1% (97.6–98.8)
Ejection Sensitivity, 23.13% (19.1–27.2);
Specificity, 63.7% (59.0–68.4)
Entrapment Sensitivity, 9.9% (8.5–11.4);
Specificity, 69.4% (65.0–73.8)
Brown et al., 2015 Sensitivity and specificity Composite outcome SBP < 110 mmHg Sensitivity, 13%;
Specificity, 93%
ISS ≥ 16, ICU admission > 24 hours, need for urgent surgery SBP < 90 mmHg Sensitivity, 5%;
Specificity, 99%
Nishijima et al., 2017 Sensitivity and specificity Composite outcome: in-hospital death or neurosurgery Anticoagulation use Sensitivity, 56% (35.3–74.5);
Specificity, 71% (69.2–73.3)
Benjamin et al., 2018 Univariable association Mortality Comorbidities
Cerebrovascular accident
Congestive heart failure		 Significant association between prognostic factor and outcome, p < 0.001
Newgard et al., 2019 Binary recursive partitioning ISS ≥ 16 or major non-orthopaedic surgical intervention Number of comorbidities
Anticoagulant use
GCS
SBP
Respiratory rate
Heart rate		 Identified as primary predictor variables:

  • GCS ≤ 14

  • SBP < 110 or > 200 mmHg

  • Respiratory rate < 10 or > 24 breaths/min

  • Heart rate < 60 or > 110 beats/minute

  • ≥ 2 comorbidities

Not identified as a primary predictor variable:

  • Anticoagulant use

CART = classification and regression trees; EMS = emergency medical services; GCS = Glasgow Coma Scale; ICU = intensive care unit; ISS = Injury Severity Score; SBP = systolic blood pressure.