ArticleThe British journal of surgery2020
Trauma models to identify major trauma and mortality in the prehospital setting.
Article in The British journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06740409 (Can the Modified Rapid Emergency Medicine Score), which is not on this map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Can the Modified Rapid Emergency Medicine Score (mREMS) Predict Trauma Patients' Outcomes in a Deteriorated Health System After Decades of Conflict?
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Substantial heterogeneity in trauma triage tool characteristic operationalization for identification of major trauma: a hybrid systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Accuracy of pre-hospital triage tools for major trauma: a systematic review with meta-analysis and net clinical benefit.World journal of emergency surgery : WJES · 2021Pooled it
- Early Risk Stratification of Severe Trauma in the Emergency Department: Integrating Clinical Scoring Systems, Dynamic Biomarkers, and Artificial Intelligence-A Narrative Review.Therapeutics and clinical risk management · 2026Review
- Comparative statistical performance of prehospital scoring systems with and without incorporating age for predicting multiple trauma outcomes: an observational study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Observational
- Assessing and Addressing Model Trustworthiness Trade-offs in Trauma Triage.International journal of artificial intelligence tools : architectures, languages, algorithms · 2024Article
- Predictors of Short-Term Trauma Laparotomy Outcomes in an Integrated Military-Civilian Health System: A 23-Year Retrospective Cohort Study.Journal of clinical medicine · 2024Article
- Epidemiology of patients assessed for trauma by Swedish ambulance services: a retrospective registry study.BMC emergency medicine · 2024Article
- Risk factors for early death in severe non-brain-injured trauma patients.World journal of emergency medicine · 2024Article
- Identifying Trauma Patients in Need for Emergency Surgery in the Prehospital Setting: The Prehospital Prediction of In-Hospital Emergency Treatment (PROPHET) Study.Journal of clinical medicine · 2023Article
- Epidemiology of severe trauma in Navarra for 10 years: out-of-hospital/ in-hospital deaths and survivors.BMC emergency medicine · 2023Article
- Prehospital Trauma Scoring Systems for Evaluation of Trauma Severity and Prediction of Outcomes.Medicina (Kaunas, Lithuania) · 2023Observational
- Which curve is better? A comparative analysis of trauma scoring systems in a South Asian country.Trauma surgery & acute care open · 2023Article
- From Death Triad to Death Tetrad-The Addition of a Hypotension Component to the Death Triad Improves Mortality Risk Stratification in Trauma Patients: A Retrospective Cohort Study.Diagnostics (Basel, Switzerland) · 2022Article
- A comparison of agreement between actigraphy and polysomnography for assessing sleep during posttraumatic amnesia.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- Machine Learning-Based Text Analysis to Predict Severely Injured Patients in Emergency Medical Dispatch: Model Development and Validation.Journal of medical Internet research · 2022Article
- The Risk Factors for Mortality among Septic Trauma Patients: A Retrospective Cohort Study Using the National Trauma Data Bank.Emergency medicine international · 2022Article
- Article
- ICD-10 based machine learning models outperform the Trauma and Injury Severity Score (TRISS) in survival prediction.PloS one · 2022Article
- Injured patients who would benefit from expedited major trauma centre care: a consensus-based definition for the United Kingdom.British paramedic journal · 2021Article
- Longitudinal Analyses of the Reciprocity of Depression and Anxiety after Traumatic Brain Injury and Its Clinical Implications.Journal of clinical medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with major trauma might benefit from treatment in a trauma centre, but early identification of major trauma (Injury Severity Score (ISS) over 15) remains difficult. The aim of this study was to undertake an external validation of existing prognostic models for injured patients to assess their ability to predict mortality and major trauma in the prehospital setting.
methodsPrognostic models were identified through a systematic literature search up to October 2017. Injured patients transported by Emergency Medical Services to an English hospital from the Trauma Audit and Research Network between 2013 and 2016 were included. Outcome measures were major trauma (ISS over 15) and in-hospital mortality. The performance of the models was assessed in terms of discrimination (concordance index, C-statistic) and net benefit to assess the clinical usefulness.
resultsA total of 154 476 patients were included to validate six previously proposed prediction models. Discriminative ability ranged from a C-statistic value of 0·602 (95 per cent c.i. 0·596 to 0·608) for the Mechanism, Glasgow Coma Scale, Age and Arterial Pressure model to 0·793 (0·789 to 0·797) for the modified Rapid Emergency Medicine Score (mREMS) in predicting in-hospital mortality (11 882 patients). Major trauma was identified in 52 818 patients, with discrimination from a C-statistic value of 0·589 (0·586 to 0·592) for mREMS to 0·735 (0·733 to 0·737) for the Kampala Trauma Score in predicting major trauma. None of the prediction models met acceptable undertriage and overtriage rates.
conclusionCurrently available prehospital trauma models perform reasonably in predicting in-hospital mortality, but are inadequate in identifying patients with major trauma. Future research should focus on which patients would benefit from treatment in a major trauma centre.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.