Multivariate analysis of patients with blunt trauma and possible factors affecting mortality

Özpek, Adnan; Yücel, Metin; Atak, İbrahim; Baş, Gürhan; Ali̇moğlu, Orhan

doi:10.5505/tjtes.2015.43077

Cited by 7 publications

(7 citation statements)

References 23 publications

(37 reference statements)

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“…Accidental falls (low impact) accounted for 27.3% of the cases with assault and railway accidents responsible for the rest. Similar to other recent studies,[ 1 ] most of the patients in our study were between 21 and 40 years of age. The mortality in patients >50 years was 13.25% as against 9% in those below 50 years of age.…”

Section: Discussionsupporting

confidence: 92%

“…found hemodynamic instability and need for transfusion to be reliable predictors of mortality in all trauma patients. [ 1 ] A low GCS due to underlying head injury cannot be modified except through the management of head injury.…”

Section: Discussionmentioning

confidence: 99%

“…Blunt chest injuries generally need the placement of a tube thoracostomy. [ 1 ] Higher investigations such as CT are done even if X-rays are positive because there is high suspicion of additional undiagnosed injury if patient is hemodynamically stable. A good example is aortic injury, which cannot be diagnosed by X-rays.…”

Section: Discussionmentioning

confidence: 99%

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Studying morbidity and predicting mortality in patients with blunt chest trauma using a novel clinical score

Manay

Satoskar

Karthik

et al. 2017

J Emerg Trauma Shock

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Background:A departmental audit in March 2015 revealed significant mortality rate of 40% in blunt chest trauma patients (much greater than the global 25%). A study was thus planned to study morbidity and predictors of mortality in blunt chest trauma patients admitted to our hospital.Methods:This study was a prospective observational study of 139 patients with a history of blunt chest trauma between June 2015 and November 2015 after the Institutional Ethics Committee approval in April 2015. The sample size was calculated from the prevalence rate in our institute from the past medical records.Results:The morbidity factors following blunt chest injuries apart from pain were need for Intensive Care Unit stay, mechanical ventilation, and pneumonia/acute respiratory distress syndrome. Significant predictors of mortality in our study were SpO2 <80 at the time of presentation, Glasgow coma scale ≤ 8, patients with four or more rib fractures, presence of associated head injury, Injury Severity Score >16, and need for mechanical ventilation. By calculating the likelihood ratios of each respiratory sign, a clinical score was devised.Conclusion:The modifiable factors affecting morbidity and mortality were identified. Mild to moderate chest injury due to blunt trauma is difficult to diagnose. The restoration of respiratory physiology has not only significant implications on recovery from chest injury but also all other injuries. It is our sincere hope that the score we have formulated will help reduce mortality and morbidity after further trials.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Studying morbidity and predicting mortality in patients with blunt chest trauma using a novel clinical score

Manay

Satoskar

Karthik

et al. 2017

J Emerg Trauma Shock

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“…This imbalance was largely due to inclusion criteria being met at a lower rate among women than men (most commonly due to anemia) and to women being less willing to donate blood for reasons such as breastfeeding. However, studies involving actual patients with trauma have also involved higher numbers of male patients than female patients …”

Section: Discussionmentioning

confidence: 99%

Effect of Changes in Intravascular Volume on Inferior Vena Cava and Aorta Diameters and the Caval/Aorta Index in Healthy Volunteers

Bılgın

Yamanoğlu

Payza

et al. 2019

J of Ultrasound Medicine

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Objectives Although inferior vena cava diameter (IVCD) measurement can be useful as a noninvasive method for monitoring the volume status, the benefit of abdominal aorta diameter (AAD) measurement is unclear. The purpose of this study was to determine the value of the combined use of the IVCD and AAD in blood loss monitoring. Methods This prospective observational study was conducted at the blood donor center of a training and research hospital. Standard blood donation criteria were followed during volunteer enrollment. Vital signs and ultrasound IVCD and AAD measurements were obtained before and after blood donation and after fluid resuscitation with 500 mL of 0.9% sodium chloride. Measurements before and after blood donation and after fluid resuscitation were compared by the paired t and Wilcoxon matched‐pair tests. Results Thirty‐nine volunteers were included in the study. With 500 mL of blood loss, percent changes in the shock index (SI; mean ± SD, 7% ± 6%), IVCD (6% ± 2%), and caval/aorta index (IVCD/AAD; 6.1% ± 3%) were similar and were higher (P < .001 for all parameters) than the changes in the pulse rate (3% ± 4%), AAD (0.5% ± 1.5%), systolic blood pressure (3% ± 4%), and diastolic blood pressure (2% ± 7%). Although IVCD and SI values changed significantly (P < .001 for both) after 500 mL of 0.9% sodium chloride resuscitation, no significant change was observed in the IVCD/AAD (P = .059). Conclusions The IVCD/AAD, SI, and IVCD may have similar success rates in diagnosing early blood loss. Additionally, the SI and IVCD may be superior to the IVCD/AAD in bleeding patients requiring simultaneous fluid resuscitation.

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“…The reported incidence of blunt abdominal trauma is 90%. [7] Ozpek et al [8] have reported the most frequent causes of blunt abdominal trauma as motor vehicle accidents in 62% and fall from heights as 27% of the cases. Mortality is seen in nearly 10% of the cases.…”

Section: Introductionmentioning

confidence: 99%

Abdominal Travmada Mortaliteyi Etkileyen Risk Faktörlerinin Analizi

Gönültaş

Kutlutürk

Gök

et al. 2019

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:The present study aims to analyze blunt and penetrating abdominal traumas that were evaluated in our emergency department, the treatment approaches and risk factors of mortality.METHODS: Six hundred and sixty-four patients were admitted to our emergency department for surgical evaluation for trauma between January 2009 and April 2019. After the exclusion of dead on arrival, patients with missing data and patients without abdominal trauma were excluded from this study. Hundred and thirteen patients with abdominal trauma admitted to our department were evaluated in this study. Demographic, clinical, prognostic and mortality related factors were retrospectively analyzed. RESULTS:The mean age of the patients was 36.08±16.1 years. There were 90 male patients. Eighty patients (70.8%) had blunt abdominal trauma (BAT). Twenty-eight patients (24.7%) had isolated liver and two patients (1.7%) had isolated spleen injury. Combined liver and spleen injury was found in two patients (1.7%). Twenty-two (19.4%) patients had mortality. Causes of mortality were an irreversible hemorrhagic shock (40.9%) and central nervous system (13.6%) injuries. BAT was the main mechanism of injury in patients with mortality (86.4% versus 67%; p<0.001). The frequency of retroperitoneal injury was significantly higher in patients with mortality (50% versus 16.5%, p<0.001). The frequency of extra-abdominal injury in patients with mortality was higher (68.1% versus 49.4%; p=0.047). Mean arterial pressure at admission was found to be significantly lower in patients with mortality (67±26.8 mmHg versus 84.3±17 mmHg; p=0.02). The number of packed erythrocytes transfused in patients with mortality was higher (8.8±8.6 versus 3.3±5.9 units; p=0.047). Mean international normalized ratio (INR) was significantly higher in patients with mortality (4.3±7.1 versus 2.7±4; p=0.016). Mean lactate dehydrogenase level was higher in patients with mortality (1685.7±333.8 versus 675.8±565.3 IU/mL; p<0.001). Mean alanine aminotransferase (ALT) was significantly higher in patients with mortality (430±619 versus 244±448 IU/mL; p<0.001). Mean alkaline phosphatase (ALP) level in patients with mortality was higher (76.9±72.8 versus 67.3±27.8 IU/mL; p=0.003). The presence of retroperitoneal injury and ALT >516 IU/mL were independent risk factors o mortality. CONCLUSION:We have found certain laboratory variables to increase in patients with mortality. These are related to the severity of trauma. Retroperitoneal injury and increased ALT levels being risk factors of mortality is the most important finding of this study. Our results can guide other centers in the evaluation of trauma patients, and high-risk groups can be identified.

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Multivariate analysis of patients with blunt trauma and possible factors affecting mortality

Abstract: BACKGROUND:This study aimed to investigate the signs and prognosis of the patients hospitalized due to blunt trauma injuries and identify possible factors that affect mortality.

Cited by 7 publications

References 23 publications

Studying morbidity and predicting mortality in patients with blunt chest trauma using a novel clinical score

Studying morbidity and predicting mortality in patients with blunt chest trauma using a novel clinical score

Effect of Changes in Intravascular Volume on Inferior Vena Cava and Aorta Diameters and the Caval/Aorta Index in Healthy Volunteers

Abdominal Travmada Mortaliteyi Etkileyen Risk Faktörlerinin Analizi

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