Índices de gravidade em vítimas de trauma contuso na terapia intensiva: capacidade preditiva de mortalidade

Lima, Kézia Porto; Nogueira, Lilia de Souza; Barbosa, Genesis de Souza; Bonfim, Ane Karoline Silva; Sousa, Regina Márcia Cardoso de

doi:10.1590/s1980-220x2020003203747

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…In this context, trauma indices have been developed over the years to determine the severity of patients, which assess the severity level of anatomical injuries and/or the physiological conditions of them by using uniform language, making it possible to estimate the survival probability of the trauma patients. These systems have been used to assist in evaluating the care provided and planning emergency care, in addition to enabling documentation of the severity in the description of the epidemiological characteristics of the trauma victims 4,5. In daily practice, trauma nurses continuously plan and make decisions about nursing interventions6 that are influenced by severity of trauma patients.…”

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confidence: 99%

“…These systems have been used to assist in evaluating the care provided and planning emergency care, in addition to enabling documentation of the severity in the description of the epidemiological characteristics of the trauma victims. 4,5 In daily practice, trauma nurses continuously plan and make decisions about nursing interventions 6 that are influenced by severity of trauma patients. Therefore, the reliability of severity indices is within the scope of interest of the trauma nurses.…”

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confidence: 99%

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Performance of the Modified Rapid Emergency Medicine Score in Patients With and Without Traumatic Brain Injury

Barbosa

Gaspar

Nogueira

et al. 2022

Journal of Neuroscience Nursing

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BACKGROUND: The modified Rapid Emergency Medicine Score (mREMS) is a recently published index to estimate the severity of trauma patients; however, little is known about its performance in patients with different types of trauma. This study verified the predictive capacity of mREMS in-hospital mortality in patients of blunt and penetrating trauma with and without traumatic brain injury (TBI) and the performance of this index compared with the Rapid Emergency Medicine Score, Injury Severity Score, New Injury Severity Score, and Trauma and Injury Severity Score. METHODS: This is a retrospective, correlational study that analyzed trauma patients 18 years or older, who attended at a hospital in Rio de Janeiro, Brazil. The receiver operating characteristic (ROC) curve was applied in the analyses. RESULTS: The sample consisted of 987 patients, 359 (36.4%) with TBI (225 blunt and 134 penetrating trauma). Regarding mREMS, the area under the ROC curve for TBI patients for in-hospital mortality was 0.506 (95% confidence interval [CI], 0.404-0.609) for penetrating injuries and 0.486 (95% CI, 0.402-0.571) for blunt injuries; the values in patients without TBI were 0.629 (95% CI, 0.554-0.703) and 0.618 (95% CI, 0.552-0.684), respectively. In relation to the other indices the mREMS presented the lowest area under the curve/ROC for penetrating and blunt TBI, and the Rapid Emergency Medicine Score for extracranial injuries. CONCLUSION: The mREMS showed no prognostic capacity for patients with TBI, and it presented the worst performance in relation to the Injury Severity Score, New Injury Severity Score, and Trauma and Injury Severity Score to discriminate cases of in-hospital mortality when considering trauma patients with and without TBI.

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confidence: 99%

Performance of the Modified Rapid Emergency Medicine Score in Patients With and Without Traumatic Brain Injury

Barbosa

Gaspar

Nogueira

et al. 2022

Journal of Neuroscience Nursing

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“…Esses cinco componentes recebem valores de zero a +4 no cálculo do REMS e a pontuação atribuída à idade varia de zero a seis. A capacidade preditiva de mortalidade desse instrumento tem sido similar a outros índices que estimam a gravidade do trauma de pacientes em unidades de terapia intensiva e na emergência(18) .O REMS foi elaborado mediante regressão logística que analisou diversas características clínicas dos pacientes. Sua composição inclui os preditores independentes para mortalidade identificados em análise multivariada.…”

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Vítimas Com Traumatismo Cranioencefálico Na Sala De Emergência E Fator Associado À Permanência No Setor

Silva

Nogueira

Sousa

2021

Rev. baiana enferm.

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<p>Objetivo: analisar a evolução das vítimas de traumatismo cranioencefálico contuso na sala de emergência e identificar fatores independentes para tempo de permanência nesse serviço. Método: coorte prospectiva que incluiu todas as vítimas que atenderam aos critérios de elegibilidade e foram admitidas entre julho e dezembro de 2017 em hospital referência para trauma. Foi aplicado o Rapid Emergency Medicine Score para identificar a evolução das vítimas até 6 horas após admissão e aplicadas estatísticas descritivas e análise bivariada. Resultados: entre a admissão e 2 horas, foram observadas mudanças desfavoráveis em 35,1% das vítimas, entre 2-4 horas em 13,6% e entre 4-6 horas, em 42,8%; foi observada melhora entre 27% e 28,6% da casuística. Suporte hemodinâmico foi fator independente para tempo de permanência. Conclusão: a evolução desfavorável foi mais frequente entre a admissão e 2 horas e após 4 horas. A maior permanência na sala de emergência ocorreu em vítimas com suporte hemodinâmico.</p><p>Descritores: Traumatismos Craniocerebrais. Traumatismos Cranianos Fechados. Serviço Hospitalar de Emergência. Enfermagem em Emergência. Resultado do Tratamento.</p>

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Performance of severity indices for admission and mortality of trauma patients in the intensive care unit: a retrospective cohort study

Rio,

Nogueira,

Lima

et al. 2023

Eur J Med Res

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Background Little is known about the performance of severity indices for indicating intensive care and predicting mortality in the Intensive Care Unit (ICU) of trauma patients. This study aimed to compare the performance of severity indices to predict trauma patients’ ICU admission and mortality. Methods A retrospective cohort study which analyzed the electronic medical records of trauma patients aged ≥ 18 years, treated at a hospital in Brazil, between 2014 and 2017. Physiological [Revised Trauma Score (RTS), New Trauma Score (NTS) and modified Rapid Emergency Medicine Score (mREMS)], anatomical [Injury Severity Score (ISS) and New Injury Severity Score (NISS)] and mixed indices [Trauma and Injury Severity Score (TRISS), New Trauma and Injury Severity Score (NTRISS), Base-deficit Injury Severity Score (BISS) and Base-deficit and New Injury Severity Score (BNISS)] were compared in analyzing the outcomes (ICU admission and mortality) using the Area Under the Receiver Operating Characteristics Curves (AUC–ROC). Results From the 747 trauma patients analyzed (52.5% female; mean age 51.5 years; 36.1% falls), 106 (14.2%) were admitted to the ICU and 6 (0.8%) died in the unit. The ISS (AUC 0.919) and NISS (AUC 0.916) had better predictive capacity for ICU admission of trauma patients. The NISS (AUC 0.949), TRISS (AUC 0.909), NTRISS (AUC 0.967), BISS (AUC 0.902) and BNISS (AUC 0.976) showed excellent performance in predicting ICU mortality. Conclusions Anatomical indices showed excellent predictive ability for admission of trauma patients to the ICU. The NISS and the mixed indices had the best performances regarding mortality in the ICU.

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Índices de gravidade em vítimas de trauma contuso na terapia intensiva: capacidade preditiva de mortalidade

Cited by 4 publications

References 21 publications

Performance of the Modified Rapid Emergency Medicine Score in Patients With and Without Traumatic Brain Injury

Performance of the Modified Rapid Emergency Medicine Score in Patients With and Without Traumatic Brain Injury

Vítimas Com Traumatismo Cranioencefálico Na Sala De Emergência E Fator Associado À Permanência No Setor

Performance of severity indices for admission and mortality of trauma patients in the intensive care unit: a retrospective cohort study

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