{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T23:48:51Z","timestamp":1784159331549,"version":"3.55.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>Objective: Many current trauma mortality prediction tools are either too intricate or rely on data not readily available during a trauma patient\u2019s initial evaluation. Moreover, none are tailored to those necessitating urgent or emergent surgery. Our objective was to design a practical, user-friendly scoring tool using immediately available variables, and then compare its efficacy to the widely-known Revised Trauma Score (RTS). Methods: The adult 2017-2021 Trauma Quality Improvement Program (TQIP) database was queried to identify patients \u226518 years old undergoing any urgent\/emergent operation (direct from Emergency Department to operating room). Patients were divided into derivation and validation groups. A three-step methodology was used. First, multiple logistic regression models were created to determine risk of death using only variables available upon arrival. Second, the weighted average and relative impact of each independent predictor was used to derive an easily calculated Immediate Operative Trauma Assessment Score (IOTAS). We then validated IOTAS using AUROC and compared it to RTS. Results: From 249\u00a0208 patients in the derivation-set, 14\u00a0635 (5.9%) died. Age \u226565, Glasgow Coma Scale score &lt;9, hypotension (SBP &lt;90\u00a0mmHg), and tachycardia (&gt;120\/min) on arrival were identified as independent predictors for mortality. Using these, the IOTAS was structured, offering scores between 0-8. The AUROC for this was .88. A clear escalation in mortality was observed across scores: from 4.4% at score 1 to 60.5% at score 8. For the validation set (250\u00a0182 patients; mortality rate 5.8%), the AUROC remained consistent at .87, surpassing RTS\u2019s AUROC of .83. Conclusion: IOTAS is a novel, accurate, and now validated tool that is intuitive and efficient in predicting mortality for trauma patients requiring urgent or emergent surgeries. It outperforms RTS, and thereby may help guide clinicians when determining the best course of action in patient management as well as counseling patients and their families.<\/jats:p>","DOI":"10.1177\/00031348241248784","type":"journal-article","created":{"date-parts":[[2024,4,20]],"date-time":"2024-04-20T01:14:55Z","timestamp":1713575695000},"page":"2463-2470","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Immediate Operative Trauma Assessment Score: A Simple and Reliable Predictor of Mortality in Trauma Patients Undergoing Urgent\/Emergent Surgery"],"prefix":"10.1177","volume":"90","author":[{"given":"Elliot","family":"Silver","sequence":"first","affiliation":[{"name":"UC Irvine Medical Center, Orange, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffry","family":"Nahmias","sequence":"additional","affiliation":[{"name":"UC Irvine Medical Center, Orange, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lekawa","sequence":"additional","affiliation":[{"name":"UC Irvine Medical Center, Orange, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Inaba","sequence":"additional","affiliation":[{"name":"University of Southern California, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Schellenberg","sequence":"additional","affiliation":[{"name":"University of Southern California, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"De Virgilio","sequence":"additional","affiliation":[{"name":"Harbor-UCLA, Torrance, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areg","family":"Grigorian","sequence":"additional","affiliation":[{"name":"UC Irvine Medical Center, Orange, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,4,19]]},"reference":[{"issue":"9","key":"bibr1-00031348241248784","first-page":"1","volume":"70","author":"Heron M","year":"2021","journal-title":"Natl Vital Stat Rep"},{"key":"bibr2-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001838"},{"key":"bibr3-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0b013e3282f1e7a4"},{"key":"bibr4-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa052049"},{"key":"bibr5-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1177\/00031348231175488"},{"key":"bibr6-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003481"},{"key":"bibr7-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2019.09.019"},{"key":"bibr8-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000006802"},{"key":"bibr9-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-198905000-00017"},{"key":"bibr10-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1186\/cc10348"},{"key":"bibr11-00031348241248784","volume-title":"National Trauma Data Bank Annual Report","author":"Chang MC","year":"2016"},{"key":"bibr12-00031348241248784","first-page":"167","author":"Gionis AMH","year":"2007","journal-title":"ACM Trans Knowl Discov Data"},{"key":"bibr13-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1177\/00031348211024192"},{"key":"bibr14-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-023-07141-y"},{"key":"bibr15-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1097\/XCS.0000000000000667"},{"key":"bibr16-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2008.04.011"},{"key":"bibr17-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2021-212184"},{"key":"bibr18-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199011000-00008"},{"key":"bibr19-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.143.1.7063747"},{"key":"bibr20-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000753"},{"key":"bibr21-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000119689.81910.06"},{"key":"bibr22-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2020.10.051"},{"key":"bibr23-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003449"},{"key":"bibr24-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-005-0063-8"},{"key":"bibr25-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000200840.89685.b0"},{"key":"bibr26-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318241f073"},{"key":"bibr27-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182ab0763"},{"key":"bibr28-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181cc4a67"},{"key":"bibr29-00031348241248784","doi-asserted-by":"publisher","DOI":"10.1186\/cc12851"},{"key":"bibr30-00031348241248784","doi-asserted-by":"publisher","DOI":"10.29252\/beat-060208"},{"key":"bibr31-00031348241248784","doi-asserted-by":"publisher","DOI":"10.3171\/2016.1.JNS152385"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348241248784","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348241248784","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348241248784","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:40:01Z","timestamp":1777380001000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348241248784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,19]]},"references-count":31,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1177\/00031348241248784"],"URL":"https:\/\/doi.org\/10.1177\/00031348241248784","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,19]]}}}