Background: There is a lack of well-validated clinical decision tools to assist clinicians with risk stratification of bleeding trauma patients.
Objective: This thesis derives and validates a clinical prediction score in order to identify patients requiring major interventions for traumatic hemorrhage.
Methods: We created a model based on the pre-specification of predictors. We conducted a systematic review of prediction models and a survey of traumatologists to identify candidate predictors. We conducted a derivation study of 748 trauma patients from 2014 to 2017.
Results: The final model included systolic BP, clinical exam, lactate, FAST and CT. The c-statistic was 0.953 (naïve) and 0.952 following optimism-correction with bootstrap validation.
Discussion: This thesis utilizes pre-specification to minimize reliance on small datasets and potential for over-optimism. Pre-specification is based on the best available knowledge within the literature and clinical expert community.
Conclusion: A simple score is proposed for risk stratification of bleeding trauma patients.
| Identifer | oai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/37311 |
| Date | January 2018 |
| Creators | Tran, Alexandre |
| Contributors | Vaillancourt, Christian |
| Publisher | Université d'Ottawa / University of Ottawa |
| Source Sets | Université d’Ottawa |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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