Cover: A Trauma Mortality Prediction Model Based on the ICD-10-CM Lexicon

A Trauma Mortality Prediction Model Based on the ICD-10-CM Lexicon


Published in: Journal of Trauma and Acute Care Surgery, Volume 86, Issue 5, pages 891-895 (May 2019). doi: 10.1097/TA.0000000000002194

Posted on Jan 28, 2021

by Turner M. Osler, Laurent G. Glance, Alan Cook, Jeffery S. Buzas, David W. Hosmer


Outcome prediction models allow risk adjustment required for trauma research and the evaluation of outcomes. The advent of ICD-10-CM has rendered risk adjustment based on ICD-9-CM codes moot, but as yet no risk adjustment model based on ICD-10-CM codes has been described.


The National Trauma Data Bank provided data from 773,388 injured patients who presented to one of 747 trauma centers in 2016 with traumatic injuries ICD-10-CM codes and Injury Severity Score (ISS). We constructed an outcome prediction model using only ICD-10-CM acute injury codes and compared its performance with that of the ISS.


Compared with ISS, the TMPM-ICD-10 discriminated survivors from non-survivors better (ROC TMPM-ICD-10 = 0.861 [0.860-0.872], ROC [reviever operating curve] ISS = 0.830 [0.823-0.836]), was better calibrated (HL [Hosmer-Lemeshow statistic] TMPM-ICD-10 = 49.01, HL ISS = 788.79), and had a lower Akaike information criteria (AIC TMPM-ICD10 = 30579.49; AIC ISS = 31802.18).


Because TMPM-ICD10 provides better discrimination and calibration than the ISS and can be computed without recourse to Abbreviated Injury Scale coding, the TMPM-ICD10 should replace the ISS as the standard measure of overall injury severity for data coded in the ICD-10-CM lexicon.

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