Clinical indicators as prognostic factors of multi-trauma patients in the Intensive Care Unit

Abstract

Background: In recent years, there has been a growing interest in understanding the role of prognostic factors in patient outcome.Aim: To investigate the role of clinical indicators, and severity-of-disease assessment scales, as prognostic factors in the outcome of multi-trauma patients in the ICU.Material and Method: The sample consisted of 65 ICU multi-trauma patients treated in a hospital in Thessaloniki city, with an average stay of 16.5 days. Clinical indicators such as Glasgow Coma Scale, heart rate, mean arterial pressure, lactic acid, hemoglobin, urine output, as well as APACHE II and SAPS II scales, were recorded on the day of admission to the ICU.Data analysis: Data were analyzed using multiple logistic regression and Mann-Whitney Test. Multiple logistic regression analysis was performed to examine the predictive capacity of specific indicators on patient outcome.Results: The results of the analysis showed that in cases where all clinical indicators changed, then patient outcome may be affected by 79,4% (Relative Risk 3.846, p<0.001). Glasgow Coma Scale (p=0.022) and hemoglobin (p=0.013) were the strongest influencing factors related to patient outcome. Mann-Whitney analysis was used to evaluate the predictive value of Apache II and SAPS II and demonstrated that both systems could significantly predict patient outcome (APACHE II=0.019 and SAPS II=0.013).Conclusion: Hemoglobin and Glasgow Coma Scale values upon multi-trauma patient admission to the ICU appear to be strong prognostic factors of patient outcome.

Incidence and predictors of mortality among traumatic brain injury patients admitted to Amhara region Comprehensive Specialized Hospitals, northwest Ethiopia, 2022

“…This finding is parallel with studies conducted in different countries like Qatar [ 27 ], Uganda [ 37 ], Tanzania [ 32 ], Rwanda [ 34 ], Sub-Saharan Africa [ 15 ], Hawassa University Hospital [ 5 ], TASH [ 3 ], and Felegehiwot comprehensive specialized hospital [ 14 ]. The possible reason could be those patients with lower GCS scores are unable to protect their airways and they are at risk of aspiration, have poor infection prevention, are not a candidate for neurosurgery, and have less access to intensive care unit settings [ 40 ]. This research found that neurosurgical interventions are associated with the greatest decrement in the hazard of death among TBI patients.…”

Prolonged time to recovery and its predictors among trauma patients admitted to the intensive care units in comprehensive specialized hospitals in Northwest Ethiopia: a multicenter retrospective follow-up study, 2022

“…This was in line with the studies conducted in Ayder Tertiary Hospital, Ethiopia ( 9 ), Kenya ( 28 ), and Turkey ( 29 ). The possible reason could be that those patients with reduced GCS scores are at high risk of aspiration, have compromised ventilator effort, and are at risk of developing intracranial hypertension, which reduces cerebral perfusion and leads to secondary cerebral attacks and death ( 30 ). Maintaining oxygenation and preventing hypercarbia by preventing aspiration, providing supplemental oxygen, and supporting ventilation are critical in managing trauma patients, especially those who have lower GCS scores ( 16 ).…”