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{
    "pk": 17532,
    "title": "Prehospital mSOFA Score for Quick Prediction of Life-Saving Interventions and Mortality in Trauma Patients: A Prospective, Multicenter, Ambulance-based, Cohort Study",
    "subtitle": null,
    "abstract": "Background:\n Prehospital emergency medical services (EMS) are the main gateway for trauma patients. Recent advances in point-of-care testing and the development of early warning scores have allowed EMS to improve patient classification. We aimed to identify patients presenting with major trauma involving life-saving interventions (LSI) using the modified Sequential Organ Failure Assessment (mSOFA) score in the prehospital scenario, and to compare these results with those of other trauma scores.\nMethods: \nThis was a prospective, ambulance-based, multicenter, training-validation study in trauma patients who were treated in a prehospital setting and subsequently transported to a hospital. The study involved six Advanced Life Support units, 38 Basic Life Support units, and four hospitals. The primary outcome was LSI performed at the scene or en route and intensive care unit (ICU) admission and all-cause two-day in-hospital mortality. We collected epidemiological variables, creatinine, lactate, base excess, international normalized ratio, and vital signs. Discriminative power (area under the receiver operating characteristic curve [AUC]), calibration (observed vs predicted outcome agreement), and decision-curve analysis (DCA, clinical utility) were used to assess the reliability of the mSOFA in comparison to other scores.\nResults: \nBetween January 1, 2020–April 30, 2022, a total of 763 patients were selected. The mSOFA score’s AUC was 0.927 (95% confidence interval [CI] 0.898–0.957) for LSI, 0.845 (95% CI 0.808–0.882) for ICU admission, and 0.979 (95% CI 0.966–0.991) for two-day mortality.\nConclusion:\n The mSOFA score outperformed the other scores, allowing a quick identification of high-risk patients. The routine implementation in EMS of mSOFA could provide critical support in the decision-making process in time-dependent trauma injuries.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "life-saving interventions"
        },
        {
            "word": "prehospital"
        },
        {
            "word": "Trauma"
        },
        {
            "word": "mSOFA"
        },
        {
            "word": "ICU"
        },
        {
            "word": "Mortality"
        }
    ],
    "section": "Emergency Medical Services",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/5zz0w01x",
    "frozenauthors": [
        {
            "first_name": "Francisco",
            "middle_name": "",
            "last_name": "Martin-Rodriguez",
            "name_suffix": "",
            "institution": "Universidad de Valladolid, Faculty of Medicine, Valladolid, Spain; Emergency Medical Services (SACYL), Advanced Life Support, Valladolid, Spain; Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain",
            "department": "None"
        },
        {
            "first_name": "Ancor",
            "middle_name": "",
            "last_name": "Sanz-Garcia",
            "name_suffix": "",
            "institution": "Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain; Universidad de Castilla la Mancha, Faculty of Health Sciences, Talavera de la Reina, Spain",
            "department": "None"
        },
        {
            "first_name": "Ana",
            "middle_name": "",
            "last_name": "Benito Justel",
            "name_suffix": "",
            "institution": "Emergency Medical Services (SACYL), Advanced Life Support, Valladolid, Spain",
            "department": "None"
        },
        {
            "first_name": "Almudena",
            "middle_name": "",
            "last_name": "Morales Sánchez",
            "name_suffix": "",
            "institution": "Emergency Medical Services (SACYL), Advanced Life Support, Valladolid, Spain",
            "department": "None"
        },
        {
            "first_name": "Cristina",
            "middle_name": "",
            "last_name": "Mazas Perez Oleaga",
            "name_suffix": "",
            "institution": "Universidad Europea del Atlántico, Department of Emergency Medicine, Santader, Spain; Universidad Internacional Iberoamericana, Department of Emergency Medicine, Campeche, México",
            "department": "None"
        },
        {
            "first_name": "Irene",
            "middle_name": "",
            "last_name": "Delgado Noya",
            "name_suffix": "",
            "institution": "Universidad Europea del Atlántico, Department of Emergency Medicine, Santader, Spain; Universidade Internacional do Cuanza, Department of Emergency Medicine, Cuito, Bié, Angola",
            "department": "None"
        },
        {
            "first_name": "Irene",
            "middle_name": "",
            "last_name": "Sánchez Soberón",
            "name_suffix": "",
            "institution": "Emergency Medical Services (SACYL), Advanced Life Support, Valladolid, Spain",
            "department": "None"
        },
        {
            "first_name": "Carlos",
            "middle_name": "",
            "last_name": "del Pozo Vegas",
            "name_suffix": "",
            "institution": "Universidad de Valladolid, Faculty of Medicine, Valladolid, Spain; Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain; Hospital Clínico Universitario, Department of Emergency Medicine, Valladolid, Spain",
            "department": "None"
        },
        {
            "first_name": "Juan",
            "middle_name": "F.",
            "last_name": "Delgado Benito",
            "name_suffix": "",
            "institution": "Emergency Medical Services (SACYL), Advanced Life Support, Valladolid, Spain; Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain",
            "department": "None"
        },
        {
            "first_name": "Raúl",
            "middle_name": "",
            "last_name": "López-Izquierdo",
            "name_suffix": "",
            "institution": "Universidad de Valladolid, Faculty of Medicine, Valladolid, Spain; Prehospital Early Warning Scoring-System Investigation Group, Valladolid, Spain; Hospital Universitario Rio Hortega, Department of Emergency Medicine, Valladolid, Spain",
            "department": "None"
        }
    ],
    "date_submitted": "2022-09-29T06:02:40-04:00",
    "date_accepted": "2022-09-29T06:02:40-04:00",
    "date_published": "2023-08-08T14:49:49-04:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/17532/galley/8939/download/"
        }
    ]
}