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- Bakidou, Anna, 1996, et al.
(author)
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On Scene Injury Severity Prediction (OSISP) model for trauma developed using the Swedish Trauma Registry
- 2023
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In: BMC Medical Informatics and Decision Making. - 1472-6947. ; 23:1
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Journal article (peer-reviewed)abstract
- Background: Providing optimal care for trauma, the leading cause of death for young adults, remains a challenge e.g., due to field triage limitations in assessing a patient’s condition and deciding on transport destination. Data-driven On Scene Injury Severity Prediction (OSISP) models for motor vehicle crashes have shown potential for providing real-time decision support. The objective of this study is therefore to evaluate if an Artificial Intelligence (AI) based clinical decision support system can identify severely injured trauma patients in the prehospital setting. Methods: The Swedish Trauma Registry was used to train and validate five models – Logistic Regression, Random Forest, XGBoost, Support Vector Machine and Artificial Neural Network – in a stratified 10-fold cross validation setting and hold-out analysis. The models performed binary classification of the New Injury Severity Score and were evaluated using accuracy metrics, area under the receiver operating characteristic curve (AUC) and Precision-Recall curve (AUCPR), and under- and overtriage rates. Results: There were 75,602 registrations between 2013–2020 and 47,357 (62.6%) remained after eligibility criteria were applied. Models were based on 21 predictors, including injury location. From the clinical outcome, about 40% of patientswere undertriaged and 46% were overtriaged. Models demonstrated potential for improved triaging and yielded AUC between 0.80–0.89 and AUCPR between 0.43–0.62. Conclusions: AI based OSISP models have potential to provide support during assessment of injury severity. The findings may be used for developing tools to complement field triage protocols, with potential to improve prehospital trauma care and thereby reduce morbidity and mortality for a large patient population.
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2. |
- Runefors, Marcus, et al.
(author)
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Factors contributing to survival and evacuation in residential fires involving older adults in Sweden
- 2021
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In: Fire safety journal. - : Elsevier. - 0379-7112 .- 1873-7226. ; 122
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Journal article (peer-reviewed)abstract
- It has been known for a long time that older adults suffer a significantly higher risk of dying in residential fires compared to younger people. The characteristics of these fatal fires and the fatalities are also well known. However, less is known about older adults who survive fires and how they differ from those who die. This distinction can be assumed to be of great importance when designing effective prevention efforts. In the current paper, factors that contribute to survival of older adults (65+) has been investigated together with factors that contribute to different modes of evacuation (e.g. evacuation assisted by neighbours) based, primarily, on incident reports. The results show that fewer than half of the victims (39%) evacuated independently and many rely on evacuation assisted by neighbours (18%), first-responders (27%) or homecare personnel (8%). Living in urban areas was found to increase the odds of survival. Based on the results from the analysis of evacuation, this is likely due to a combination of proximity to neighbours and a short response time. For successful evacuation by non-firefighters, the fires often had to be confined to the object of ignition while the rescue service could evacuate from larger fires.
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