The penetrating injury risk of non-home discharge (PIRD) score: Development and validation of a predictive…

Cohort studyInjury· Aug 2026

The penetrating injury risk of non-home discharge (PIRD) score: Development and validation of a predictive tool using the National Trauma Data Bank.

Rohan Phadke, Samer Salman, Muhammad H Ilyas … Philipp Leucht

Emergency Trauma CareCohort studyPrognosisQ1IF 2.3

PIRD score predicted non-home discharge after penetrating trauma with strong accuracy.

The penetrating injury risk of non-home discharge (PIRD) score: Development and validation of a predictive tool using the National Trauma Data Bank.

Rohan Phadke … Philipp Leucht

Injury · Aug 2026 · Q1 in Emergency Medicine

Background

Penetrating trauma disproportionately affects young patients, yet many survivors cannot be discharged directly home and instead require post-acute care.

Methods

The cohort was split 2:1 into derivation and validation sets, stratified by outcome.

n = 302,399 patients

Results

AUROC; 1.0 is perfect, this score strongly separates who needs post-acute care

AUROC 0.87 (95% CI 0.86 to 0.87)

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0.86

0.87

CI excludes the null - significant

More results

Among 302,399 patients, 21,186 (7.0%) had non-home discharge.

The 40-predictor model was led by spinal-cord injury, critical injury severity (ISS ≥25), advanced age, and severe traumatic brain injury, whereas stab mechanism and private-vehicle arrival lowered the odds.

More results

Non-home discharge rose from 0.7% (low risk) to 37.5% (high risk); at a score ≥4, sensitivity was 86.0% and negative predictive value 98.5%.

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Conclusion

Derived from variables available early in care, the PIRD score accurately predicts post-acute care discharge in adult penetrating trauma and outperforms existing severity scores, supporting timely discharge planning and resource allocation.

The penetrating injury risk of non-home discharge (PIRD) score: Development and validation of a predictive tool using the National Trauma Data Bank.

The penetrating injury risk of non-home discharge (PIRD) score: Development and validation of a predictive tool using the National Trauma Data Bank.

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