APPENDIX TABLE 1A.Denver Health and Loma Linda, Complete Case – Accuracy of each predictor for Intubation (outcome).
Intubation / Sensitivity / Specificity / LR+ / LR-GCS ≤ 13 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 3,268 / 2,426 / 76.2 / (74.9 – 77.5) / 91.4 / (91.0 – 91.7) / 8.82 / (8.46 – 9.20) / 0.26 / (0.25 – 0.28)
No / 1,020 / 25,659
Intubation / Sensitivity / Specificity / LR+ / LR-
mGCS < 6 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 3,109 / 1,863 / 73.0 / (71.7 – 74.4) / 93.3 / (93.0 – 93.6) / 10.90 / (10.39 – 11.43) / 0.29 / (0.28 – 0.30)
No / 1,149 / 25,947
Intubation / Sensitivity / Specificity / LR+ / LR-
mGCS < 5 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 2,603 / 915 / 61.1 / (59.7 – 62.6) / 96.7 / (96.5 – 96.7) / 18.58 / (17.36 – 19.89) / 0.40 / (0.39 – 0.42)
No / 1,655 / 26,895
Intubation / Sensitivity / Specificity / LR+ / LR-
SMS < 2 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 3,109 / 1,863 / 73.0 / (71.7 – 74.4) / 93.3 / (93.0 – 93.6) / 10.90 / (10.39 – 11.43) / 0.29 / (0.28 – 0.30)
No / 1,149 / 25,947
Intubation / Sensitivity / Specificity / LR+ / LR-
AVPU < 4 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 3,246 / 2,314 / 76.1 / (74.8 – 77.4) / 91.7 / (91.4 – 92.1) / 9.20 / (8.82 – 9.60) / 0.26 / (0.25 – 0.28)
No / 1,020 / 25,659
APPENDIX TABLE 1B.Denver Health and Loma Linda, Complete Case – Accuracy of each predictor for CSBI (outcome).
CSBI / Sensitivity / Specificity / LR+ / LR-GCS ≤ 13 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 2,764 / 2,931 / 47.6 / (46.3 – 48.9) / 89.0 / (88.6 – 89.3) / 4.31 / (4.13 – 4.50) / 0.59 / (0.58 – 0.60)
No / 3,045 / 23,634
CSBI / Sensitivity / Specificity / LR+ / LR-
mGCS < 6 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 2,526 / 2,447 / 44.0 / (42.3 – 45.3) / 90.7 / (90.4 – 91.1) / 4.74 / (4.52 – 4.97) / 0.62 / (0.60 – 0.63)
No / 3,213 / 23,883
CSBI / Sensitivity / Specificity / LR+ / LR-
mGCS < 5 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 1,915 / 1,603 / 33.7 / (32.2 – 34.6) / 93.9 / (93.6 – 94.2) / 5.48 / (5.16 – 5.82) / 0.71 / (0.69 – 0.72)
No / 3,824 / 24,727
CSBI / Sensitivity / Specificity / LR+ / LR-
SMS < 2 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 2,526 / 2,447 / 44.0 / (42.7 – 45.3) / 90.7 / (90.4 – 91.1) / 4.74 / (4.51 – 4.97) / 0.62 / (0.60 – 0.63)
No / 3,213 / 23,883
CSBI / Sensitivity / Specificity / LR+ / LR-
AVPU < 4 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 2,725 / 2,836 / 47.2 / (45.9 – 48.5) / 89.3 / (88.9 – 89.7) / 4.41 / (4.22 – 4.61) / 0.59 / (0.58 – 0.61)
No / 3,045 / 23,634
APPENDIX TABLE 1C.Denver Health and Loma Linda, Complete Case – Accuracy of each predictor for NSI (outcome).
NSI / Sensitivity / Specificity / LR+ / LR-GCS ≤ 13 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 743 / 4,952 / 80.2 / (77.7 – 82.8) / 84.3 / (83.9 – 84.7) / 5.10 / (4.89 – 5.31) / 0.24 / (0.21 – 0.27)
No / 183 / 26,496
NSI / Sensitivity / Specificity / LR+ / LR-
mGCS < 6 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 725 / 4,248 / 78.6 / (75.9 – 81.2) / 86.4 / (86.0 – 86.7) / 5.76 / (5.51 – 6.02) / 0.25 / (0.22 – 0.28)
No / 198 / 26,898
NSI / Sensitivity / Specificity / LR+ / LR-
mGCS < 5 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 594 / 2,924 / 64.4 / (61.3 – 67.5) / 90.6 / (90.3 – 90.9) / 6.86 / (9.46 – 7.27) / 0.39 / (0.36 – 0.43)
No / 329 / 28,222
NSI / Sensitivity / Specificity / LR+ / LR-
SMS < 2 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 725 / 4,248 / 78.6 / (75.9 – 81.2) / 86.4 / (86.0 – 86.7) / 5.76 / (5.51 – 6.02) / 0.25 / (0.22 – 0.28)
No / 198 / 26,898
NSI / Sensitivity / Specificity / LR+ / LR-
AVPU < 4 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 739 / 4,822 / 80.2 / (77.6 – 82.7) / 84.6 / (84.2 – 85.0) / 5.21 / (5.00 – 5.42) / 0.24 / (0.21 – 0.27)
No / 183 / 26,496
APPENDIX TABLE 1D.Denver Health and Loma Linda, Complete Case – Accuracy of each predictor for ISS >15 (outcome).
ISS ≥ 16 / Sensitivity / Specificity / LR+ / LR-GCS ≤ 13 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 3,454 / 2,216 / 42.3 / (41.1 – 43.3) / 90.8 / (90.3 – 91.1) / 4.57 / (4.36 – 4.79) / 0.64 / (0.62 – 0.65)
No / 4,722 / 21,770
ISS ≥ 16 / Sensitivity / Specificity / LR+ / LR-
mGCS < 6 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 3,170 / 1,783 / 39.0 / (38.0 – 40.1) / 92.5 / (92.2 – 92.8) / 5.20 / (4.93 – 5.47) / 0.66 / (0.65 – 0.67)
No / 4,954 / 21,954
ISS ≥ 16 / Sensitivity / Specificity / LR+ / LR-
mGCS < 5 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 2,493 / 1,009 / 30.7 / (29.6 – 31.7 ) / 95.8 / (95.5 – 96.0) / 7.22 / (6.74 – 7.73) / 0.72 / (0.71 – 0.74)
No / 5,631 / 22,728
ISS ≥ 16 / Sensitivity / Specificity / LR+ / LR-
SMS < 2 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 3,170 / 1,783 / 39.0 / (38.0 – 40.1) / 92.5 / (92.2 – 92.8) / 5.20 / (4.93 – 5.47) / 0.66 / (0.65 – 0.67)
No / 4,954 / 21,954
ISS ≥ 16 / Sensitivity / Specificity / LR+ / LR-
AVPU < 4 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 3,422 / 2,114 / 42.0 / (41.0 – 43.1) / 91.2 / (90.8 – 91.5) / 4.74 / (4.53 – 4.98) / 0.64 / (0.62 – 0.65)
No / 4,722 / 21,770
APPENDIX TABLE 1E.Denver Health and Loma Linda, Complete Case – Accuracy of each predictor for mortality (outcome).
Mortality / Sensitivity / Specificity / LR+ / LR-GCS ≤ 13 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 1,343 / 4,352 / 83.3 / (81.5 – 85.1) / 85.9 / (85.5 – 86.2) / 5.89 / (5.69 – 6.10) / 0.19 / (0.17 – 0.22)
No / 269 / 26,408
Mortality / Sensitivity / Specificity / LR+ / LR-
mGCS < 6 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 1,316 / 3,656 / 82.1 / (80.2 – 84.0) / 88.0 / (87.6 – 88.4) / 6.84 / (6.59 – 7.11) / 0.20 / (0.18 – 0.23)
No / 287 / 26,808
Mortality / Sensitivity / Specificity / LR+ / LR-
mGCS < 5 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 1,243 / 2,275 / 77.5 / (77.5 – 79.6) / 92.5 / (92.2 – 92.8) / 10.38 / (9.90 – 10.89) / 0.24 / (0.22 – 0.27)
No / 360 / 28,189
Mortality / Sensitivity / Specificity / LR+ / LR-
SMS < 2 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 1,316 / 3,656 / 82.1 / (80.2 – 84.0) / 88.0 / (87.6 – 88.4) / 6.84 / (6.59 – 7.11) / 0.20 / (0.18 – 0.23)
No / 287 / 26,808
Mortality / Sensitivity / Specificity / LR+ / LR-
AVPU < 4 / Yes / No / % / (95% CI) / % / (95% CI) / (95% CI) / (95% CI)
Yes / 1,342 / 4,219 / 83.3 / (81.5 – 85.1) / 86.2 / (85.8 – 86.5) / 6.05 / (5.84 – 6.27) / 0.19 / (0.17 – 0.22)
No / 269 / 26,408
APPENDIX TABLE 2A.Accuracy of each predictor for each outcome (Denver Health, multiply-imputed data) (N = 15,559).
Sensitivity / Specificity / LR+ / LR-% / (95% CI) / % / (95% CI) / % / (95% CI) / % / (95% CI)
Intubation
GCS ≤ 13 / 83.2 / (81.5 – 85.0) / 65.0 / (64.2 – 65.6) / 2.38 / (2.31 – 2.46) / 0.26 / (0.23 – 0.29)
mGCS < 6 / 79.8 / (77.9 – 81.6) / 68.5 / (67.5 – 69.5) / 2.53 / (2.43 – 2.63) / 0.30 / (0.27 – 0.32)
mGCS < 5 / 71.0 / (68.8 – 73.2) / 74.5 / (73.3 – 75.6) / 2.78 / (2.64 – 2.93) / 0.39 / (0.36 – 0.42)
SMS < 2 / 79.8 / (77.9 – 81.6) / 68.5 / (67.5 – 69.5) / 2.53 / (2.43 – 2.63) / 0.30 / (0.27 – 0.32)
AVPU < 4 / 83.2 / (81.5 – 85.0) / 65.0 / (64.2 – 65.6) / 2.38 / (2.31 – 2.46) / 0.26 / (0.23 – 0.29)
CSBI
GCS ≤ 13 / 59.6 / (57.2 – 62.1) / 62.9 / (62.0 – 63.7) / 1.61 / (1.53 – 1.68) / 0.64 / (0.60 – 0.68)
mGCS < 6 / 55.9 / (53.3 – 58.4) / 66.2 / (65.2 – 67.2) / 1.66 / (1.57 – 1.74) / 0.67 / (0.63 – 0.71)
mGCS < 5 / 45.1 / (42.7 – 42.7) / 70.9 / (65.4 – 76.5) / 1.56 / (1.30 – 1.87) / 0.77 / (0.70 – 0.85)
SMS < 2 / 55.9 / (53.3 – 58.4) / 66.2 / (65.2 – 67.2) / 1.66 / (1.57 – 1.74) / 0.67 / (0.63 – 0.71)
AVPU < 4 / 59.6 / 57.2 – 62.1 / 62.9 / 62.0 – 63.7 / 1.61 / 1.53 – 1.68 / 0.64 / 0.60 – 0.68
NSI
GCS ≤ 13 / 82.3 / (79.2 – 85.5) / 60.9 / (60.1 – 61.7) / 2.11 / (2.01 – 2.20) / 0.29 / (0.24 – 0.35)
mGCS < 6 / 79.8 / (76.4 – 83.2) / 64.4 / (63.4 – 65.3) / 2.24 / (2.13 – 2.36) / 0.31 / (0.27 – 0.37)
mGCS < 5 / 66.0 / (62.0 – 70.0) / 70.4 / (69.2 – 71.5) / 2.23 / (2.07 – 2.40) / 0.48 / (0.43 – 0.54)
SMS < 2 / 79.8 / (76.4 – 83.2) / 64.4 / (63.4 – 65.3) / 2.24 / (2.13 – 2.36) / 0.31 / (0.27 – 0.37)
AVPU < 4 / 82.3 / (79.2 – 85.5) / 60.9 / (60.1 – 61.7) / 2.11 / (2.01 – 2.20) / 0.29 / (0.24 – 0.35)
ISS ≥ 16
GCS ≤ 13 / 53.7 / (47.7 – 59.6) / 63.3 / (62.4 – 64.2) / 1.46 / (1.30 – 1.64) / 0.73 / (0.65 – 0.82)
mGCS < 6 / 51.3 / (49.6 – 53.0) / 66.8 / (65.7 – 67.9) / 1.54 / (1.47 – 1.62) / 0.73 / (0.70 – 0.76)
mGCS < 5 / 42.5 / (40.7 – 44.3) / 72.4 / (71.0 – 73.8) / 1.54 / (1.44 – 1.64) / 0.79 / (0.77 – 0.82)
SMS < 2 / 51.3 / (49.6 – 53.0) / 66.8 / (65.7 – 67.9) / 1.54 / (1.47 – 1.62) / 0.73 / (0.70 – 0.76)
AVPU < 4 / 53.7 / (47.7 – 59.6) / 63.3 / (62.4 – 64.2) / 1.46 / (1.30 – 1.64) / 0.73 / (0.65 – 0.82)
Mortality
GCS ≤ 13 / 87.5 / (85.0 – 90.0) / 61.4 / (60.6 – 62.3) / 2.27 / (2.19 – 2.35) / 0.20 / (0.17 – 0.25)
mGCS < 6 / 86.5 / (83.8 – 89.1) / 65.0 / (64.1 – 66.0) / 2.47 / (2.37 – 2.57) / 0.21 / (0.17 – 0.25)
mGCS < 5 / 83.2 / (80.3 – 86.0) / 71.4 / (70.3 – 72.6) / 2.91 / (2.76 – 3.07) / 0.24 / (0.20 – 0.28)
SMS < 2 / 86.5 / (83.8 – 89.1) / 65.0 / (64.1 – 66.0) / 2.47 / (2.37 – 2.57) / 0.21 / (0.17 – 0.25)
AVPU < 4 / 87.5 / (85.0 – 90.0) / 61.4 / (60.6 – 62.3) / 2.27 / (2.19 – 2.35) / 0.20 / (0.17 – 0.25)
APPENDIX TABLE 2B.Accuracy of each predictor for each outcome (Loma Linda, multiply-imputed data) (N = 32,414).
Sensitivity / Specificity / LR+ / LR-% / (95% CI) / % / (95% CI) / % / (95% CI) / % / (95% CI)
Intubation
GCS ≤ 13 / 78.5 / (77.1 – 80.0) / 61.3 / (60.7 – 61.9) / 2.03 / (1.98 – 2.08) / 0.35 / (0.33 – 0.37)
mGCS < 6 / 74.1 / (72.5 – 75.7) / 66.8 / (66.0 – 67.6) / 2.23 / (2.16 – 2.30) / 0.39 / (0.36 – 0.41)
mGCS < 5 / 61.5 / (59.8 – 63.2) / 73.3 / (72.3 – 74.2) / 2.30 / (2.20 – 2.40) / 0.53 / (0.50 – 0.55)
SMS < 2 / 74.1 / (72.5 – 75.7) / 66.8 / (66.6 – 67.6) / 2.23 / (2.16 – 2.30) / 0.39 / (0.36 – 0.41)
AVPU < 4 / 78.5 / (77.1 – 80.0) / 61.3 / (60.7 – 61.9) / 2.03 / (1.98 – 2.08) / 0.35 / (0.33 – 0.37)
CSBI
GCS ≤ 13 / 65.3 / (64.1 – 66.5) / 61.3 / (52.4 – 70.2) / 1.70 / (1.39 – 2.07) / 0.57 / (0.49 – 0.67)
mGCS < 6 / 58.0 / (56.6 – 59.4) / 67.5 / (66.7 – 68.3) / 1.79 / (1.73 – 1.84) / 0.62 / (0.60 – 0.64)
mGCS < 5 / 47.0 / (45.6 – 48.4) / 73.7 / (72.8 – 74.6) / 1.79 / (1.72 – 1.85) / 0.72 / (0.70 – 0.74)
SMS < 2 / 58.0 / (56.6 – 59.4) / 67.5 / (66.7 – 68.3) / 1.79 / (1.73 – 1.84) / 0.62 / (0.60 – 0.64)
AVPU < 4 / 65.3 / (64.1 – 66.5) / 61.3 / (52.4 – 70.2) / 1.70 / (1.39 – 2.07) / 0.57 / (0.49 – 0.67)
NSI
GCS ≤ 13 / 85.3 / (82.3 – 88.3) / 57.9 / (57.3 – 58.4) / 2.02 / (1.95 – 2.10) / 0.25 / (0.21 – 0.31)
mGCS < 6 / 81.0 / (77.4 – 84.5) / 63.2 / (62.5 – 64.0) / 2.20 / (2.11 – 2.30) / 0.30 / (0.25 – 0.36)
mGCS < 5 / 68.5 / (64.0 – 73.1) / 70.3 / (69.4 – 71.1) / 2.31 / (2.16 – 2.46) / 0.45 / (0.39 – 0.52)
SMS < 2 / 81.0 / (77.4 – 84.5) / 63.2 / (62.5 – 64.0) / 2.20 / (2.11 – 2.30) / 0.30 / (0.25 – 0.36)
AVPU < 4 / 85.3 / (82.3 – 88.3) / 57.9 / (57.3 – 58.4) / 2.02 / (1.95 – 2.10) / 0.25 / (0.21 – 0.31)
ISS > 15
GCS ≤ 13 / 56.8 / (55.2 – 58.5) / 61.5 / (60.8 – 62.2) / 1.48 / (1.42 – 1.54) / 0.70 / (0.67 – 0.73)
mGCS < 6 / 50.8 / (49.0 – 52.6) / 65.4 / (57.4 – 73.3) / 1.47 / (1.19 – 1.83) / 0.75 / (0.65 – 0.87)
mGCS < 5 / 41.5 / (39.7 – 43.4) / 73.1 / (72.2 – 74.0) / 1.54 / (1.47 – 1.62) / 0.80 / (0.78 – 0.63)
SMS < 2 / 50.8 / (49.0 – 52.6) / 65.4 / (57.4 – 73.3) / 1.47 / (1.19 – 1.83) / 0.75 / (0.65 – 0.87)
AVPU < 4 / 56.8 / (55.2 – 58.5) / 61.5 / (60.8 – 62.2) / 1.48 / (1.42 – 1.54) / 0.70 / (0.67 – 0.73)
Mortality
GCS ≤ 13 / 85.0 / (83.0 – 87.0) / 58.7 / (58.1 – 59.3) / 2.06 / (2.00 – 2.12) / 0.26 / (0.22 – 0.29)
mGCS < 6 / 82.8 / (80.6 – 85.1) / 64.2 / (63.4 – 65.0) / 2.31 / (2.23 – 2.39) / 0.27 / (0.24 – 0.31)
mGCS < 5 / 77.4 / (75.0 – 79.9) / 71.4 / (70.5 – 72.3) / 2.71 / (2.59 – 2.83) / 0.32 / (0.28 – 0.35)
SMS < 2 / 82.8 / (80.6 – 85.1) / 64.2 / (63.4 – 65.0) / 2.31 / (2.23 – 2.39) / 0.27 / (0.24 – 0.31)
AVPU < 4 / 85.0 / (83.0 – 87.0) / 58.7 / (58.1 – 59.3) / 2.06 / (2.00 – 2.12) / 0.26 / (0.22 – 0.29)
APPENDIX TABLE 3A.Multiply-imputedareas under receiver operating characteristics (AUROC) curves for each predictorand outcome (Denver Health, imputed data) (N = 15,559).
Intubation / CSBI / NSI / ISS > 15 / MortalityAUROC / (95% CI) / AUROC / (95% CI) / AUROC / (95% CI) / AUROC / (95% CI) / AUROC / (95% CI)
GCS / 81.9 / (80.7 – 83.0) / 65.6 / (64.5 – 66.8) / 77.3 / (75.5 – 79.3) / 63.0 / (61.8 – 64.1) / 85.8 / (84.1 – 87.5)
GCS ≤ 13 / 74.1 / (73.2 – 78.1) / 61.4 / (60.3 – 62.4) / 71.6 / (70.0 – 73.3) / 58.9 / (58.0 – 59.9) / 74.4 / (73.1 – 75.8)
mGCS < 6 / 74.1 / (73.1 – 75.2) / 61.2 / (60.1 – 62.3) / 72.1 / (70.3 – 73.9) / 59.0 / (58.0 – 60.0) / 75.7 / (74.3 – 77.1)
mGCS < 5 / 72.7 / (71.5 – 73.9) / 58.5 / (57.3 – 59.7) / 68.2 / (66.1 – 70.3) / 57.4 / (56.3 – 58.6) / 77.3 / (75.8 – 78.8)
SMS / 75.1 / (74.0 – 76.3) / 60.9 / (59.7 – 62.0) / 72.0 / (70.1 – 73.9) / 59.0 / (57.8 – 60.1) / 77.9 / (76.4 – 79.5)
SMS < 2 / 74.1 / (73.1 – 75.2) / 61.2 / (60.1 – 62.3) / 72.1 / (70.3 – 73.9) / 59.0 / (58.0 – 60.0) / 75.7 / (74.3 – 77.1)
AVPU / 81.2 / (80.0 – 82.4) / 63.4 / (62.2 – 64.6) / 76.1 / (74.2 – 78.1) / 62.1 / (61.0 – 63.2) / 85.2 / (83.5 – 86.9)
AVPU < 4 / 74.1 / (73.2 – 78.1) / 61.4 / (60.3 – 62.4) / 71.6 / (70.0 – 73.3) / 58.9 / (58.0 – 59.9) / 74.4 / (73.1 – 75.8)
APPENDIX TABLE 3B.Multiply-imputed areas under receiver operating characteristics (AUROC) curves for each predictor and outcome (Loma Linda, imputed data) (N = 32,414).
Intubation / CSBI / NSI / ISS > 15 / MortalityAUROC / (95% CI) / AUROC / (95% CI) / AUROC / (95% CI) / AUROC / (95% CI) / AUROC / (95% CI)
GCS / 76.1 / (75.1 – 77.1) / 67.5 / (66.8 – 68.3) / 77.5 / (75.6 – 79.3) / 62.4 / (61.2 – 63.6) / 83.5 / (82.0 – 84.9)
GCS ≤ 13 / 69.9 / (69.2 – 70.7) / 64.0 / (63.3 – 64.7) / 71.6 / (70.0 – 73.1) / 59.2 / (58.2 – 60.2) / 71.9 / (70.8 – 72.9)
mGCS < 6 / 70.4 / (69.5 – 71.3) / 62.7 / (62.0 – 63.5) / 72.1 / (70.3 – 73.9) / 58.7 / (57.7 – 59.7) / 73.5 / (72.3 – 74.7)
mGCS < 5 / 67.4 / (66.4 – 68.3) / 60.3 / (59.7 – 61.0) / 69.4 / (67.2 – 71.6) / 57.3 / (56.4 – 58.2) / 74.4 / (73.1 – 75.7)
SMS / 70.7 / (69.8 – 71.7) / 62.8 / (62. – 63.5) / 72.7 / (70.8 – 74.6) / 58.8 / (57.8 – 59.8) / 75.5 / (74.2 – 76.8)
SMS < 2 / 70.4 / (69.5 – 71.3) / 62.7 / (62.0 – 63.5) / 72.1 / (70.3 – 73.9) / 58.7 / (57.7 – 59.7) / 73.5 / (72.3 – 74.7)
AVPU / 74.7 / (73.7 – 75.7) / 65.3 / (64.5 – 66.0) / 76.0 / (74.0 – 78.1) / 60.7 / (59.5 – 61.9) / 82.0 / (80.6 – 83.4)
AVPU < 4 / 69.9 / (69.2 – 70.7) / 64.0 / (63.3 – 64.7) / 71.6 / (70.0 – 73.1) / 59.2 / (58.2 – 60.2) / 71.9 / (70.8 – 72.9)
APPENDIX TABLE 4. Sensitivity analyses of the 854.x ICD-9 code for clinically significant brain injury (CSBI) among complete case datasets.
Denver Health(including 854.x) / Denver Health
(excluding 854.x) / Loma Linda
(2003 – 2013)
(including 854.x) / Loma Linda
(2003 – 2013)
(excluding 854.x) / Loma Linda
(2014 – 2015)
Total / N = 15,559 / N = 15,559 / N = 27,430 / N = 27,430 / N = 4,984
Total, Complete case / n = 11,309 / n = 11,309 / n = 17,967 / n = 17,967 / n = 3,098
(95% CI) / (95% CI) / (95% CI) / (95% CI) / (95% CI)
GCS ≤ 13
Sensitivity / 52.3 / (50.2 – 54.5) / 52.0 / (49.9 – 54.2) / 30.3 / (29.2 – 31.4) / 45.6 / (43.9 – 47.3) / 40.9 / (36.5 – 45.3)
Specificity / 87.5 / (86.8 – 88.2) / 87.3 / (86.6 – 88.0) / 90.1 / (89.6 – 90.6) / 88.9 / (88.5 – 89 .4) / 59.1 / (54.5 – 63.5)
LR+ / 4.6 / (4.3 – 5.0) / 4.1 / (3.8 – 4.4) / 3.1 / (2.9 – 3.2) / 4.2 / (4.0 – 4.5) / 5.7 / (4.8 – 6.8)
LR- / 0.5 / (0.5 – 0.6) / 0.5 / (0.5 – 0.6) / 0.8 / (0.8 – 0.8) / 0.6 / (0.6 – 0.6) / 0.6 / (0.6 – 0.7)
mGCS < 6
Sensitivity / 49.5 / (47.3 – 51.7) / 49.2 / (46.9 – 51.4) / 27.1 / (26.0 – 28.1) / 41.5 / (39.8 – 43.2) / 38.6 / (36.5 – 45.3)
Specificity / 89.5 / (88.9 – 90.1) / 89.3 / (88.7 – 90.0) / 91.5 / (91.0 – 91.9) / 90.5 / (90.1 – 91.0) / 61.4 / (57.0 – 66.7)
LR+ / 4.7 / (4.4 – 5.1) / 4.6 / (4.3 – 5.0) / 3.2 / (3.0 – 3.4) / 4.6 / (4.3 – 4.9) / 6.3 / (5.2 – 7.6)
LR- / 0.6 / (0.5 – 0.6) / 0.6 / (0.5 – 0.6) / 0.8 / (0.8 – 0.8) / 0.6 / (0.6 – 0.7) / 0.6 / (0.6 – 0.7)
mGCS < 5
Sensitivity / 38.6 / (36.4 – 40.7) / 38.2 / (36.1 – 40.3) / 19.1 / (18.2 – 20.1) / 30.6 / (29.0 – 32.1) / 31.1 / (27.0 – 35.3)
Specificity / 92.6 / (91.1 – 93.1) / 92.4 / (89.5 – 90.1) / 94.4 / (94.0 – 95.8) / 93.9 / (93.6 – 94.3) / 68.9 / (64.8 – 73.0)
LR+ / 5.2 / (4.7 – 5.7) / 3.6 / (3.3 – 3.9) / 3.4 / (3.1 – 3.7) / 5.5 / (5.0 – 6.0) / 7.1 / (5.7 – 8.9)
LR- / 0.7 / (0.6 – 0.7) / 0.7 / (0.7 – 0.7) / 0.8 / (0.8 – 0.9) / 0.7 / (0.7 – 0.8) / 0.7 / (0.7 – 0.8)
SMS < 3
Sensitivity / 49.5 / (47.3 – 51.7) / 49.2 / (46.9 – 51.4) / 27.1 / (26.0 – 28.2) / 41.5 / (39.8 – 43.2) / 38.6 / (36.5 – 45.3)
Specificity / 89.5 / (88.9 – 90.1) / 89.3 / (88.7 – 90.0) / 91.5 / (91.0 – 91.9) / 90.5 / (90.1 – 91.0) / 61.4 / (57.0 – 65.7)
LR+ / 4.7 / (4.4 – 5.1) / 4.6 / (4.3 – 5.0) / 3.4 / (3.1 – 3.7) / 4.6 / (4.3 – 4.9) / 6.3 / (5.2 – 7.6)
LR- / 0.6 / (0.5 – 0.6) / 0.6 / (0.5 – 0.6) / 0.8 / (0.8 – 0.9) / 0.6 / (0.6 – 0.7) / 0.6 / (0.6 – 0.7)
AVPU < 4
Sensitivity / 51.4 / (49.2 – 53.6) / 51.1 / (48.9 – 53.3) / 30.3 / (29.2 – 31.4) / 45.6 / (43.9 – 47.3) / 40.9 / (36.5 – 45.3)
Specificity / 88.4 / (87.7 – 89.1) / 88.2 / (87.6 – 88.9) / 90.1 / (89.6 – 90.6) / 88.9 / (88.5 – 89 .4) / 59.1 / (54.7 – 63.5)
LR+ / 4.4 / (4.1 – 4.8) / 4.3 / (4.0 – 4.7) / 3.1 / (2.9 – 3.2) / 4.2 / (4.0 – 4.5) / 5.7 / (4.8 – 6.8)
LR- / 0.6 / (0.5 – 0.6) / 0.6 / (0.5 – 0.6) / 0.8 / (0.8 – 0.8) / 0.6 / (0.6 – 0.6) / 0.6 / (0.6 – 0.7)
APPENDIX TABLE 5. Areas under the receiver operating characteristics (AUROC) curve for clinically significant brain injury (CSBI) among complete case datasets.
Denver Health(including 854.x) / Denver Health
(excluding 854.x) / Loma Linda
(2003 – 2013)
(including 854.x) / Loma Linda
(2003 – 2013)
(excluding 854.x) / Loma Linda
(2014 – 2015)
TOTAL / N = 15,559 / N = 15,559 / N = 27,430 / N = 27,430 / N = 4,984
Total, Complete case / n = 11,309 / n = 11,309 / n = 17,967 / n = 17,967 / n = 3,098
AUROC / (95% CI) / AUROC / (95% CI) / AUROC / (95% CI) / AUROC / (95% CI) / AUROC / (95% CI)
GCS / 0.75 / (0.74 – 0.76) / 0.75 / (0.74 – 0.76) / 0.66 / (0.65 – 0.66) / 0.73 / (0.72 – 0.74) / 0.73 / (0.70 – 0.75)
GCS ≤ 13 / 0.70 / (0.69 – 0.71) / 0.70 / (0.69 – 0.71) / 0.61 / (0.60 – 0.61) / 0.67 / (0.65 – 0.68) / 0.67 / (0.65 – 0.69)
mGCS < 6 / 0.69 / (0.68 – 0.71) / 0.69 / (0.68 – 0.70) / 0.60 / (0.59 – 0.60) / 0.66 / (0.65 – 0.67) / 0.66 / (0.64 – 0.68)
mGCS < 5 / 0.66 / (0.64 – 0.67) / 0.65 / (0.64 – 0.66) / 0.57 / (0.57 – 0.58) / 0.62 / (0.62 – 0.63) / 0.63 / (0.61 – 0.65)
SMS / 0.70 / (0.69 – 0.71) / 0.69 / (0.68 – 0.71) / 0.60 / (0.59 – 0.60) / 0.66 / (0.65 – 0.67) / 0.66 / (0.64 – 0.69)
SMS < 3 / 0.69 / (0.68 – 0.71) / 0.69 / (0.68 – 0.71) / 0.60 / (0.59 – 0.60) / 0.66 / (0.65 – 0.67) / 0.66 / (0.64 – 0.68)
AVPU / 0.70 / (0.69 – 0.71) / 0.70 / (0.69 – 0.71) / 0.61 / (0.60 – 0.61) / 0.68 / (0.67 – 0.69) / 0.67 / (0.65 – 0.69)
AVPU < 4 / 0.70 / (0.69 – 0.71) / 0.70 / (0.69 – 0.71) / 0.61 / (0.60 – 0.61) / 0.67 / (0.66 – 0.68) / 0.67 / (0.65 – 0.69)