Predicting mortality of geriatric trauma patients in Hong Kong—A comparison of scoring systems: GERtality score, Geriatric Trauma Outcome Score

Abstract

Abstract Introduction Various scoring systems have been devised in attempt to prognosticate and predict outcomes in trauma. This study aims to assess the comparative performance of the GERtality and Geriatric Trauma Outcome Score (GTOS) scores in predicting mortality of geriatric trauma patients in Hong Kong. Methods This is a single‐centre, retrospective cohort study, utilising anonymised data from the Trauma Registry of Hong Kong for all geriatric patients (age ≥65) from 1 January, 2023 to 31 December 2023 from one trauma centre. Receiver Operating Characteristic (ROC) Curve construction of GERtality and GTOS with Area‐Under Receiver Operating Characteristic Curve (AUROC) calculation, assessing both the end‐points of 30‐day mortality and in‐hospital mortality were made. The same ROC and AUROC analyses were done for GERtality and GTOS with the modification of the ‘PRBC transfusion’ variable for the secondary outcome. Results All models performed better at predicting in‐hospital mortality than 30‐day mortality. No statistical significance was found between GERtality and GTOS for either endpoints. GTOS performed better than GERtality on 30‐day mortality AUC 0.850 versus 0.825. GERtality perfomed better than GTOS on in‐hospital mortality AUC 0.876 versus 0.868. There was no statistically significant difference between GERtality and RISC‐II for subset data when predicting in‐hospital mortality, which was present for GTOS. The ‘PRBC transfused at the ED’ variable yielded the highest AUC when substituted into either scores to predict in‐hospital mortality with the highest being GERtality T‐ED at AUC 0.887. Conclusions Both GERtality and GTOS can be used to predict 30‐day or in‐hospital mortality in non‐ICU restricted geriatric trauma patients in Hong Kong.

Keywords

• aged
• forecasting
• geriatrics
• hospital mortality
• trauma severity indices