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Nakhjavan-Shahraki B, Baikpour M, Yousefifard M, et al. Rapid Acute Physiology Score versus Rapid Emergency Medicine Score in Trauma Outcome Prediction; a Comparative Study. Emerg (Tehran). 2017;5(1):e30
Nakhjavan-Shahraki, B., Baikpour, M., Yousefifard, M., Nikseresht, Z. S., Abiri, S., Mirzay Razaz, J., Faridaalaee, G., Pouraghae, M., Shirzadegan, S., & Hosseini, M. (2017). Rapid Acute Physiology Score versus Rapid Emergency Medicine Score in Trauma Outcome Prediction; a Comparative Study. Emergency (Tehran, Iran), 5(1), e30.
Nakhjavan-Shahraki, Babak, et al. "Rapid Acute Physiology Score versus Rapid Emergency Medicine Score in Trauma Outcome Prediction; a Comparative Study." Emergency (Tehran, Iran) vol. 5,1 (2017): e30.
Nakhjavan-Shahraki B, Baikpour M, Yousefifard M, Nikseresht ZS, Abiri S, Mirzay Razaz J, Faridaalaee G, Pouraghae M, Shirzadegan S, Hosseini M. Rapid Acute Physiology Score versus Rapid Emergency Medicine Score in Trauma Outcome Prediction; a Comparative Study. Emerg (Tehran). 2017;5(1):e30. Epub 2017 Jan 10. PMID: 28286837; PMCID: PMC5325900.
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Emerg (Tehran). 2017;5(1):e30. Epub 2017 Jan 10.

Rapid Acute Physiology Score versus Rapid Emergency Medicine Score in Trauma Outcome Prediction; a Comparative Study.

Emergency (Tehran, Iran)

Babak Nakhjavan-Shahraki, Masoud Baikpour, Mahmoud Yousefifard, Zahra Sadat Nikseresht, Samaneh Abiri, Jalaledin Mirzay Razaz, Gholamreza Faridaalaee, Mahboob Pouraghae, Sahar Shirzadegan, Mostafa Hosseini

Affiliations

  1. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  2. Department of Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  3. Physiology Research Center and Department of Physiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
  4. Department of Emergency Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
  5. Department of Community Nutrition, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  6. Department of Emergency Medicine, Maragheh University of Medical Sciences, Maragheh, Iran.
  7. Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran.
  8. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

PMID: 28286837 PMCID: PMC5325900

Abstract

INTRODUCTION: Rapid acute physiology score (RAPS) and rapid emergency medicine score (REMS) are two physiologic models for measuring injury severity in emergency settings. The present study was designed to compare the two models in outcome prediction of trauma patients presenting to emergency department (ED).

METHODS: In this prospective cross-sectional study, the two models of RAPS and REMS were compared regarding prediction of mortality and poor outcome (severe disability based on Glasgow outcome scale) of trauma patients presenting to the EDs of 5 educational hospitals in Iran (Tehran, Tabriz, Urmia, Jahrom and Ilam) from May to October 2016. The discriminatory power and calibration of the models were calculated and compared using STATA 11.

RESULTS: 2148 patients with the mean age of 39.50±17.27 years were studied (75.56% males). The area under the curve of REMS and RAPS in predicting in-hospital mortality were calculated to be 0.93 (95% CI: 0.92-0.95) and 0.899 (95% CI: 0.86-0.93), respectively (p=0.02). These measures were 0.92 (95% CI: 0.90-0.94) and 0.86 (95% CI: 0.83-0.90), respectively, regarding poor outcome (p=0.001). The optimum cut-off point in predicting outcome was found to be 3 for REMS model and 2 for RAPS model. The sensitivity and specificity of REMS and RAPS in the mentioned cut offs were 95.93 vs. 85.37 and 77.63 vs. 83.51, respectively, in predicting mortality. Calibration and overall performance of the two models were acceptable.

CONCLUSION: The present study showed that adding age and level of arterial oxygen saturation to the variables included in RAPS model can increase its predictive value. Therefore, it seems that REMS could be used for predicting mortality and poor outcome of trauma patients in emergency settings.

Keywords: Multiple trauma; decision support techniques; patient outcome assessment; prognosis; trauma severity indices

Conflict of interest statement

The authors report no declarations of interest.

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