Investigation of Frequency of the Lethal Triad and Its 24 Hours Prognostic Value among Patients with Multiple Traumas

Abstract

BACKGROUND: Death in multiple trauma (MT) patients is one of the serious concerns of the medical service provider. Any prediction of the likelihood of death on the assessment of the patient's condition is performed using different variables, one of the tools in the triage of patients to determine their condition.
 AIM: We aimed to investigate the frequency and the predictive value of death in 24 hours triad of death in patients qualified with multiple traumas admitted to Imam Khomeini hospital.
 METHODS: This was a prospective cross-sectional study to determine the prevalence and predictive value of 24-hour triad of death among patients with MT referred to an emergency department. Three factors including acidosis, hypothermia and coagulopathy and predictive value of 24-hour death were evaluated. Arterial blood gas, oral temperature and blood samples for coagulation factors were analysed. Data were analysed using SPSS version 19. Multivariate analysis (logistic regression) was used to determine the predictive value of the triad of death.
 RESULTS: A group of 199 MT patients referring to Imam Khomeini hospital during the first 6 months of 2015 were evaluated for the first 24 hours of admission. Logistic regression analysis showed that using the following formula based on the triad of death can predict death in 96% of cases can be based on the triad of a death foretold death upon admission to the emergency room. It should be noted that this prediction tool as 173 people left alive after 24 hours as live predicts (100% correct).
 CONCLUSION: The triad of death is one of the tools in the triage of patients to determine their condition and care plan to be used, provided valuable information to predict the prognosis of patients with a medical team.

<p>Relationship Between Initial Arterial Blood Gases and Coagulation Profiles – Analyzing the Prognosis and Outcomes in Patients with Multiple Injuries/Trauma</p>

“…This is consistent with the earlier reports which were conducted in other regions such as India 17 and Iran, which are also recognized as developing regions. 14 Concerning the clinical characteristics of the patients, RTA is observed to be the most primary source of trauma among the patients. This is because of the increasing traffic on the road and its development as an urban setting.…”

“…The present study conducted a laboratory assessment of the patients based on its objectivity for measuring the resuscitation adequacy. 14…”

Consideraciones sobre la tríada letal para predecir mortalidad en pacientes con trauma mayor

“…Dentro de las fortalezas de este estudio está la representación de los pacientes con trauma mayor con una muestra significativa, esto hace que los resultados tengan mayor impacto en el desarrollo científico en esta área del conocimiento en ciencias de la salud. 9 En conclusión, la sensibilidad de la triada letal en el estudio fue de 0.02, con especificidad de 1, y valores predictivos negativos de 1 y de 0.9 respectivamente, considerándose así no determinante en la mortalidad de los pacientes con trauma severo. La principal limitación del estudio es la característica retrospectiva de la recolección de datos, lo que puede influir en el resultado.…”

Effect of seawater immersion on pathophysiological changes in rats combined burns with open abdominal injury

“…The medical treatment on the ship is very di cult due to the limited conditions, heavy waves and swaying. After soaked in sea water, the wounded are prone to trigger fatal complications such as hypothermia, acidosis and coagulation dysfunction [3] . In addition to the effect of hypertonic seawater, the water and electrolyte of the wounded are easily disordered, resulting in severe hypertonic dehydration, hypersodium and hyperchloremia [4] , and high wound infection rate, especially vibrio infection [5] .Therefore, the wounded combined with seawater immersion, suffered serious injuries and had a high mortality rate.…”