Factors predicting the early mortality of trauma patients

Abstract

BACKGROUND:The aim of this study was to identify factors predicting early mortality in trauma patients. METHODS:This was a study of 6288 trauma patients admitted to the hospital between July 2011 and June 2016. Among the variables recorded for a prospective trauma registry, the following were selected for analysis: sex; age; a combination of the Glasgow Coma Scale score, age, and systolic blood pressure (SBP) (GAP); a combination of the mechanism of injury, the Glasgow Coma Scale score, age, and SBP (MGAP); SBP; respiratory rate; peripheral oxygen saturation (SpO 2 value); the Glasgow Coma Scale score; laboratory variables; and presentation time. Logistic regression analysis was used to explore associations between these variables and early mortality. RESULTS:In total, 296 (4.6%) patients died within 24 hours. Univariate regression analysis indicated that age, the GAP, the MGAP, SBP, SpO 2 , the Glasgow Coma Scale score, base excess, hemoglobin level, platelet count, INR, and presentation time predicted early mortality. Multivariate regression showed that the GAP, the MGAP, SpO 2 , base excess, platelet count, and INR were independently predictive. The areas under the receiver operator curve comparisons for the GAP and MGAP models revealed the superiority of the GAP-based model. CONCLUSION:The GAP model, SpO 2 , base excess, platelet count, and INR predicted the early mortality of trauma patients.

The ratio of shock index to pulse oxygen saturation predicting mortality of emergency trauma patients

“…On the contrary, A prospective study [15] showed that SpO 2 was a better parameter than RR and could add significant value to other variables in predicting mortality in trauma patients. Otherwise, A recent study revealed pragmatic value of SpO 2 in trauma and indicated that SPO 2 can effectively predict the 24-hour mortality of trauma patients [1].…”

“…The vast majority of the previous studies on the prediction of early in trauma patients are based on the mortality in-hospital or 28 days [3,6,9,19,21,22], not early mortality in the emergency room. A recent study [1] Identified variables that can be quickly measured to predict 24-hour early mortality, showing that SPO2 < 90% can be used to predict early mortality. However, it did not address the correlation between SI and early mortality in trauma patients.…”

“…Compared with SI, our subjects SS included SpO2 and the reasons were as follows. It was reported that indicators corelated with microcirculation perfusion were important predictors of mortality in trauma patients, such as lactate clearance, base deficit and so on [1,18,22]. Therefore, it is valuable to include these predictors in the method of predicting mortality in general trauma population.…”

“…A study reported that SpO 2 do not add significant value to other variables when predicting mortality in severe trauma patients [7]. However, some researches believed that SPO 2 can effectively predict the early mortality of trauma patient [1,8]. These results demonstrate a need to further evaluate how vital signs affect mortality of trauma patients.…”

“…Trauma is a worldwide public health issue, causing serious economic and medical burdens [1]. Trauma patients have many symptoms, serious injuries, rapid and changeable disease progress, and there is a risk of death at any time.…”