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Master of Public Health

Artificial Neural Networks Can Predict Trauma Volume and Acuity Regardless of Center Size and Geography: a multicenter study

AUTHORS

Dennis BM , Stonko DP , Callcut RA , Sidwell RA , Stassen NA , Cohen MJ , Cotton BA , Guillamondegui OD , . The journal of trauma and acute care surgery. 2019 4 23; ().

ABSTRACT

BACKGROUND: Trauma has long been considered unpredictable. Artificial neural networks (ANN) have recently shown the ability to predict admission volume, acuity and operative needs at a single trauma center with very high reliability. This model has not been tested in a multicenter model with differing climate and geography. We hypothesize that an artificial neural network can accurately predict trauma admission volume, penetrating trauma admissions, and mean ISS with a high degree of reliability across multiple trauma centers.

METHODS: Three years of admission data was collected from five geographically distinct US level 1 trauma centers. Patients with incomplete data, pediatric patients and primary thermal injuries were excluded. Daily number of traumas, number of penetrating cases, and mean ISS was tabulated from each center along with National Oceanic and Atmospheric Administration data from local airports. We trained a single two-layer feed-forward ANN on a random majority (70%) partitioning of data from all centers using Bayesian Regularization and minimizing mean squared error. Pearson’s product-moment correlation coefficient was calculated for each partition, each trauma center, and for high and low volume days (>1 standard deviation above or below mean total number of traumas).

RESULTS: 5,410 days were included. 43,380 traumas, including 4,982 penetrating traumas. The mean ISS was 11.78 (SD=6.12). On the training partition, we achieved R = 0.8733. On the testing partition (new data to the model), we achieved R = 0.8732, with a combined R = 0.8732. For high and low volume days, we achieved R = 0.8934 and R = 0.7963, respectively.

CONCLUSIONS: An ANN successfully predicted trauma volumes and acuity across multiple trauma centers with very high levels of reliability. The correlation was highest during periods of peak volume. This can potentially provide a framework for determining resource allocation at both the trauma system level and the individual hospital level.

LEVEL OF EVIDENCE: Level III, prognostic.

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