Trauma Risk Score Matching for Observational Studies in Orthopedic Trauma

• Published in: Injury Vol. 53; no. 2; pp. 440 - 444
• Main Authors: Parola, Rown, Ganta, Abhishek, Egol, Kenneth A., Konda, Sanjit R.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2022
• Subjects: Aged; Database Analytics; Geriatric Trauma; Hip Fracture; Hip Fractures - epidemiology; Hip Fractures - surgery; Humans; Middle Aged; Observational Studies as Topic; Orthopedic Trauma; Propensity Matching; Propensity Score Matching; Research Methods; Retrospective Studies; Risk Assessment; Risk Factors; Trauma Risk Score; Triage; Propensity Matching; Orthopedic Trauma; Database Analytics; Geriatric Trauma; Research Methods; Hip Fracture; Propensity Score Matching; Trauma Risk Score
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2021.12.009

•Matching by STTGMA or a combination of demographic variables more often led to equipoise than matching by CCI, or than would be expected by chance.•The STTGMA method of uniform matching parameters and weights may lead to more interstudy comparability relative to combination matching.•In sum, there were 8 variables with “matching failures” among CCI matched cohorts and no “matching failures” among the other matching methods. To determine if matching by trauma risk score is non-inferior to matching by chronic comorbidities and/or a combination of demographic and patient characteristics in observational studies of acute trauma in a hip fracture model. Retrospective cohort study Level-1 Trauma Center 1,590 hip fracture [AO/OTA 31A and 31B] patients age 55 and over treated between October 2014 and February 2020 at 4 hospitals within a single academic medical center. Repeatedly matching randomized subsets of patients by (1) Score for Trauma Triage in Geriatric and Middle-Aged (STTGMA), (2) Charlson Comorbidity Index (CCI), or (3) a combination of sex, age, CCI and body mass index (BMI). “Matching failures” where rate of significant differences in variables of matched cohorts exceeds the 5% expected by chance. STTGMA and combination matching resulted in no “matching failures”. Matching by CCI alone resulted in “matching failures” of BMI, ASA class, STTGMA, major complications, sepsis, pneumonia, acute respiratory failure, and 90-day readmission. STTGMA matching in observational cohort studies is less likely to yield significant differences of demographics and outcomes than CCI matching. STTGMA matching is noninferior to matching a combination of demographic variables optimized for each treatment cohort. STTGMA matching is apt to reflect equipoise of health at admission and outcome likelihood in observational cohort studies of orthopedic trauma, while maintaining consistent weighting of demographic and injury characteristic variables that may expand the generalizability of these studies. Level III