A Trauma Mortality Prediction Model Based on the ICD-10-CM Lexicon: TMPM-ICD10

Background 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. Methods 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 ISS. We constructed an outcome prediction model using only ICD-10-CM acute injury codes and compared its performance to that of the ISS. Results Compared to ISS, the TMPM-ICD-10 discriminated survivors from non-survivors better, [ROC TMPM-ICD-10 = 0.861 (0.860 – 0.872), ROC ISS = 0.830 (0.823 – 0.836)], was better calibrated [HL 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). Conclusions Because TMPM-ICD10 provides better discrimination and calibration than the ISS and can be computed without recourse to AIS 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. Level of Evidence Level II There are no conflicts of interest for any author. This work has not been previously presented. No disclosures. © 2019 Lippincott Williams & Wilkins, Inc.

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