Biochemical Markers as Predictors of In-Hospital Mortality in Patients with Severe Trauma: A Retrospective Cohort Study

Jang, Ha Nee; Park, Hyun Oh; Yang, Tae-Won; Yang, Jun; Kim, Sung Hwan; Moon, Seong Ho; Byun, Joung Hun; Lee, Chung Eun; Kim, Jong Woo; Kang, Dong Hun; Baek, Kyeong Hee

doi:10.4266/kjccm.2017.00360

Cited by 3 publications

(6 citation statements)

References 21 publications

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“…However, calculation of the RTS can be difficult because endotracheal intubation, sedation, and neuromuscular paralysis during prehospital care preclude determining either the GCS score or the spontaneous RR upon admission. [ 14 – 16 ]…”

Section: Discussionmentioning

confidence: 99%

The thorax trauma severity score and the trauma and injury severity score

et al. 2017

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Several scoring systems are commonly used to evaluate severity in patients with traumatic injuries. However, there is no generally accepted standard scoring system to assess the severity of thoracic trauma, specifically in patients who have sustained severe injuries. The present study aimed to evaluate the validity of the trauma and injury severity score (TRISS) and the thorax trauma severity score (TTSS) as predictors of in-hospital mortality in patients with severe thoracic trauma.We conducted a retrospective, consecutive review of the medical records of patients with severe thoracic trauma who were managed at our institution between January 2005 and December 2015. Inclusion criteria were patients with severe thoracic injury (injury severity score > 18) who required intensive care therapy and who had no local or systemic infection. We analyzed the association between the trauma severity scores (TTSS and TRISS) and in-hospital mortality in these patients. We also determined the predictive value of the scores using receiver-operating characteristic (ROC) curves.A total of 228 patients with severe thoracic trauma were included in this study. The in-hospital mortality rate was 21.9%. There was a statistically significant association between the TRISS and in-hospital mortality (P < .001), but the association between the TTSS and in-hospital mortality was not statistically significant (P = .547). The ROC curve demonstrated adequate discrimination, as demonstrated by an area under the curve value of 0.787 for the TRISS. At a cut-off value of 25.9%, the TRISS had a sensitivity of 83.6% and specificity of 73.5% to predict in-hospital mortality.The present study demonstrated that the TRISS, but not the TTSS, can be used to predict in-hospital mortality in patients with severe thoracic trauma; hence, additional prospective studies are required.

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Section: Discussionmentioning

confidence: 99%

The thorax trauma severity score and the trauma and injury severity score

et al. 2017

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“…Strategies implemented to identify patients with injuries associated with high mortality include the development of severity scoring systems. Several trauma scores have been developed to predict mortality among patients with trauma, of which the Injury Severity Score (ISS) is the most commonly used [6,7]. The ISS is associated with mortality, and severe trauma is defined as an ISS >15 [6].…”

Section: Introductionmentioning

confidence: 99%

“…The ISS is associated with mortality, and severe trauma is defined as an ISS >15 [6]. While it is commonly used to predict mortality, there are limits to the use of the ISS as a decision tool in the emergency setting [7]. As the calculations needed for the ISS are complex and time-consuming, they are generally used for auditing and research purposes rather than for clinical decision-making [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…While it is commonly used to predict mortality, there are limits to the use of the ISS as a decision tool in the emergency setting [7]. As the calculations needed for the ISS are complex and time-consuming, they are generally used for auditing and research purposes rather than for clinical decision-making [7,8]. To overcome this limitation, several studies have sought to identify biochemical markers or to develop new scoring systems (e.g., the Rapid Emergency Medicine Score [REMS] and Emergency Trauma Score [EMTRAS]) that can be used to predict mortality [3,7–11].…”

Section: Introductionmentioning

confidence: 99%

“…As the calculations needed for the ISS are complex and time-consuming, they are generally used for auditing and research purposes rather than for clinical decision-making [7,8]. To overcome this limitation, several studies have sought to identify biochemical markers or to develop new scoring systems (e.g., the Rapid Emergency Medicine Score [REMS] and Emergency Trauma Score [EMTRAS]) that can be used to predict mortality [3,7–11]. Unlike the ISS, using new scoring systems and biochemical markers to predict mortality has the advantage of generating scores rapidly [7–9].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of the Initial Risk Factors for Mortality among Patients with Severe Trauma on Admission to the Emergency Department

Park

Choi

Jang

et al. 2019

Korean J Thorac Cardiovasc Surg

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BackgroundFor decades, trauma has been recognized globally as a major cause of death. Reducing the mortality of patients with trauma is an extremely pressing issue, particularly for those with severe trauma. An early and accurate assessment of the risk of mortality among patients with severe trauma is important for improving patient outcomes.MethodsWe performed a retrospective medical record review of 582 patients with severe trauma admitted to the emergency department between July 2011 and June 2016. We analyzed the associations of in-hospital mortality with the baseline characteristics and initial biochemical markers of patients with severe trauma on admission.ResultsThe overall in-hospital mortality rate was 14.9%. Multivariate logistic regression analysis showed that the patient’s Rapid Emergency Medicine Score (REMS; odds ratio [OR], 1.186; 95% confidence interval [CI], 1.018–1.383; p=0.029), Emergency Trauma Score (EMTRAS; OR, 2.168; 95% CI, 1.570–2.994; p<0.001), serum lactate levels (SLL; OR, 1.298; 95% CI, 1.118–1.507; p<0.001), and Injury Severity Score (ISS; OR, 1.038; 95% CI, 1.010–1.130; p=0.021) were significantly associated with in-hospital mortality.ConclusionThe REMS, EMTRAS, and SLL can easily and rapidly be used as alternatives to the injury severity score to predict in-hospital mortality for patients who present to the emergency department with severe trauma.

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Bibliometric and visual analysis of severe trauma literature in the past 20 years

Chang,

Li,

Wang

et al. 2024

MedComm – Future Medicine

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Severe trauma is a critical aspect of medical practice, profoundly impacting patient care and outcomes. Over the past 20 years, advancements in trauma care concepts and the utilization of advanced technologies have led to substantial growth in severe trauma research, evidenced by a notable increase in research activity and subsequent publications. To understand the publication landscape in severe trauma, identify prevailing research trends, and highlight areas requiring further development for future insights, we conducted a bibliometric analysis. Our analysis indicates that there are 16,939 severe trauma‐related publications from the past 20 years, with a continuous increase in publication volume, particularly showing a rapid growth trend from 2018 to 2021. The United States leads in both volume and citation frequency. Moreover, we synthesized data on productive countries/regions and research institutions, showcasing extensive collaboration across diverse geographic locations and institutional affiliations. Substantial progress has been achieved in severe trauma research, particularly in clinical diagnosis, treatment, epidemiology, prevention, and pathogenesis. However, there is still a gap in adopting cutting‐edge interdisciplinary methodologies. This study provides a comprehensive overview of the current state of severe trauma research and suggests pathways for future advancement.

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Biochemical Markers as Predictors of In-Hospital Mortality in Patients with Severe Trauma: A Retrospective Cohort Study

Cited by 3 publications

References 21 publications

The thorax trauma severity score and the trauma and injury severity score

The thorax trauma severity score and the trauma and injury severity score

Assessment of the Initial Risk Factors for Mortality among Patients with Severe Trauma on Admission to the Emergency Department

Bibliometric and visual analysis of severe trauma literature in the past 20 years

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