Won Young Yong JİN
(Department of Emergency Medicine,Gyeongsang National University School of Medicine, Jinju-si, Gyeongsangnam-do-Republic of Korea)
Jin JEONG
(Department of Emergency Medicine,Gyeongsang National University School of Medicine, Jinju-si, Gyeongsangnam-do-Republic of Korea)
Dong KİM
(Department of Emergency Medicine,Gyeongsang National University School of Medicine, Jinju-si, Gyeongsangnam-do-Republic of Korea)
Tae KİM
(Department of Emergency Medicine,Gyeongsang National University School of Medicine, Jinju-si, Gyeongsangnam-do-Republic of Korea)
Changwoo KANG
(Department of Emergency Medicine,Gyeongsang National University School of Medicine, Jinju-si, Gyeongsangnam-do-Republic of Korea)
Soo LEE
(Department of Emergency Medicine,Gyeongsang National University School of Medicine, Jinju-si, Gyeongsangnam-do-Republic of Korea)
Sang LEE
(Department of Emergency Medicine,Gyeongsang National University School of Medicine, Jinju-si, Gyeongsangnam-do-Republic of Korea)
Seong KİM
(Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Gyeongsangnam-Republic of Korea)
Yong PARK
(Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Gyeongsangnam-Republic of Korea)
Daesung LİM
(Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Gyeongsangnam-Republic of Korea)
Yıl: 2018Cilt: 24Sayı: 6ISSN: 1306-696X / 1307-7945Sayfa Aralığı: 532 - 538İngilizce

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Factors predicting the early mortality of trauma patients
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 (SpO2 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, SpO2 , 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, SpO2 , 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, SpO2 , base excess, platelet count, and INR predicted the early mortality of trauma patients.
DergiAraştırma MakalesiErişime Açık
  • 1. Niles SE, McLaughlin DF, Perkins JG, Wade CE, Li Y, Spinella PC, et al. Increased mortality associated with the early coagulopathy of traumain combat casualties. J Trauma 2008;64:1459–63. [CrossRef ]
  • 2. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2197–223. [CrossRef ]
  • 3. Baker SP, O’Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 1974;14:187–96. [CrossRef ]
  • 4. Cap A, Hunt B. Acute traumatic coagulopathy. Curr Opin Crit Care 2014;20:638–45. [CrossRef ]
  • 5. Ono Y, Ishida T, Iwasaki Y, Kawakami Y, Inokuchi R, Tase C, et al. The off-hour effect on trauma patients requiring subspecialtyintervention at a community hospital in Japan: a retrospective cohort study. Scand J Trauma Resusc Emerg Med 2015;23:20. [CrossRef ]
  • 6. Boyd CR, Tolson MA, Copes WS. Evaluating trauma care: the TRISS method. Trauma Score and the Injury Severity Score. J Trauma 1987;27:370–8. [CrossRef ]
  • 7. Champion HR, Sacco WJ, Copes WS, Gann DS, Gennarelli TA, Flanagan ME. A revision of the Trauma Score. J Trauma 1989;29:623–9.
  • 8. Sartorius D, Le Manach Y, David JS, Rancurel E, Smail N, Thicoïpé M, Mechanism, glasgow coma scale, age, and arterial pressure (MGAP): a new simple prehospital triage score to predict mortality in traumapatients. Crit Care Med 2010;38:831–7. [CrossRef ]
  • 9. Kondo Y, Abe T, Kohshi K, Tokuda Y, Cook EF, Kukita I. Revised trauma scoring system to predict in-hospital mortality in the emergency department: Glasgow Coma Scale, Age, and Systolic Blood Pressure score. Crit Care 2011;15:R191. [CrossRef ]
  • 10. Brohi K, Singh J, Heron M, Coats T. Acute traumatic coagulopathy. J Trauma 2003;54:1127–30. [CrossRef ]
  • 11. Maegele M, Paffrath T, Bouillon B. Acute traumatic coagulopathy in severe injury: incidence, riskstratification, and treatment options. Dtsch Arztebl Int 2011;108:827–35.
  • 12. Di Bartolomeo S. The ‘off-hour’ effect in trauma care: a possible quality indicator with appealing characteristics. Scand J Trauma Resusc Emerg Med 2011;19:33. [CrossRef ]
  • 13. Jneid H, Fonarow GC, Cannon CP, Palacios IF, Kilic T, Moukarbel GV,et al. Impact of time of presentation on the care and outcomes of acute myocardial infarction. Circulation 2008;117:2502–9. [CrossRef ]
  • 14. Laupland KB, Ball CG, Kirkpatrick AW. Hospital mortality among major trauma victims admitted on weekends and evenings: a cohort study. J Trauma Manag Outcomes 2009;3:8. [CrossRef ]
  • 15. Sobrino J, Shafi S. Timing and causes of death after injuries. Proc (Bayl Univ Med Cent) 2013;26:120–3. [CrossRef ]
  • 16. Sauaia A, Moore FA, Moore EE, Moser KS, Brennan R, Read RA, et al. Epidemiology of trauma deaths: a reassessment. J Trauma 1995;38:185– 93. [CrossRef ]
  • 17. Wang H, Robinson RD, Moore B, Kirk AJ, Phillips JL, Umejiego J, et al. Predictors of early versus late mortality in pelvic trauma patients. Scand J Trauma Resusc Emerg Med 2016;24:27. [CrossRef ]
  • 18. White IR, Royston P, Wood AM. Multiple imputation using chained equations: Issues and guidance for practice. Stat Med 2011;30:377–99.
  • 19. DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 1988;44:837–45. [CrossRef ]
  • 20. Maegele M, Lefering R, Yucel N, Tjardes T, Rixen D, Paffrath T, et al. Early coagulopathy in multiple injury: an analysis from the GermanTrauma Registry on 8724 patients. Injury 2007;38:298–304.
  • 21. Ibrahim I, Chor WP, Chue KM, Tan CS, Tan HL, Siddiqui FJ, et al. Is arterial base deficit still a useful prognostic marker in trauma? A systematic review. Am J Emerg Med 2016;34:626–35. [CrossRef ]
  • 22. Huber-Wagner S, Stegmaier J, Mathonia P, Paffrath T, Euler E, Mutschler W, et al. The sequential trauma score - a new instrument for the sequential mortality prediction in major trauma. Eur J Med Res 2010;15:185–95.
  • 23. Gerdin M, Roy N, Khajanchi M, Kumar V, Dharap S, Felländer-Tsai L, et al. Predicting early mortality in adult trauma patients admitted to three public university hospitals in urban India: a prospective multicentre cohort study. PLoS One 2014;9:e105606. [CrossRef ]
  • 24. Hampton DA, Lee TH, Diggs BS, McCully SP, Schreiber MA. A predictive model of early mortality in trauma patients. Am J Surg 2014;207:642–7. [CrossRef ]
  • 25. Mitra B, Cameron PA, Mori A, Fitzgerald M. Acute coagulopathy and early deaths post major trauma. Injury 2012;43:22–5. [CrossRef ]
  • 26. Kunitake RC, Kornblith LZ, Cohen MJ, Callcut RA. Trauma Early Mortality Prediction Tool (TEMPT) for assessing 28-day mortality. Trauma Surg Acute Care Open 2018;3:e000131. [CrossRef ]
  • 27. Ahun E, Köksal Ö, Sığırlı D, Torun G, Dönmez SS, Armağan E. Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department. Ulus Travma Acil Cerrahi Derg 2014;20:241–7. [CrossRef ]
  • 28. Baghi I, Shokrgozar L, Herfatkar MR, Nezhad Ehsan K, Mohtasham Amiri Z. Mechanism of Injury, Glasgow Coma Scale, Age, and Systolic Blood Pressure: A New Trauma Scoring System to Predict Mortality in Trauma Patients. Trauma Mon 2015;20:e24473. [CrossRef ]
  • 29. Evans JA, van Wessem KJ, McDougall D, Lee KA, Lyons T, Balogh ZJ. Epidemiology of traumatic deaths: comprehensive population-based assessment. World J Surg 2010;34:158–63. [CrossRef ]
  • 30. Johansson PI, Stissing T, Bochsen L, Ostrowski SR. Thrombelastography and tromboelastometry in assessing coagulopathy in trauma. Scand J Trauma Resusc Emerg Med 2009;17:45. [CrossRef ]
  • 31. Yuan S, Ferrell C, Chandler WL. Comparing the prothrombin time INR versus the APTT to evaluate the coagulopathy of acute trauma. Thromb Res 2007;120:29–37. [CrossRef ]
  • 32. Peltan ID, Vande Vusse LK, Maier RV, Watkins TR. An International Normalized Ratio-Based Definition of Acute Traumatic Coagulopathy Is Associated With Mortality, Venous Thromboembolism, and Multiple Organ Failure After Injury. Crit Care Med 2015;43:1429–38. [CrossRef ]
  • 33. Stansbury LG, Hess AS, Thompson K, Kramer B, Scalea TM, Hess JR. The clinical significance of platelet counts in the first 24 hours after severe injury. Transfusion 2013;53:783–9. [CrossRef ]
  • 34. Sinert R, Zehtabchi S, Bloem C, Lucchesi M. Effect of normal saline infusion on the diagnostic utility of base deficit in identifying major injury in trauma patients. Acad Emerg Med 2006;13:1269–74. [CrossRef ]
  • 35. Mofidi M, Hasani A, Kianmehr N. Determining the accuracy of base deficit in diagnosis of intra-abdominal injury in patients with blunt abdominal trauma. Am J Emerg Med 2010;28:933–6. [CrossRef ]
  • 36. Sauaia A, Moore FA, Moore EE, Haenel JB, Read RA, Lezotte DC. Early predictors of postinjury multiple organ failure. Arch Surg 1994;129:39– 45. [CrossRef ]
  • 37. Davis JW, Parks SN, Kaups KL, Gladen HE, O’Donnell-Nicol S. Admission base deficit predicts transfusion requirements and risk of complications. J Trauma 1996;41:769–74. [CrossRef ]
  • 38. Eberhard LW, Morabito DJ, Matthay MA, Mackersie RC, Campbell AR, Marks JD, et al. Initial severity of metabolic acidosis predicts the development of acute lung injury in severely traumatized patients. Crit Care Med 2000;28:125–31. [CrossRef ]
  • 39. Raux M, Thicoïpé M, Wiel E, Rancurel E, Savary D, David JS, et al. Comparison of respiratory rate and peripheral oxygen saturation to assess severity in trauma patients. Intensive Care Med 2006;32:405–12.
  • 40. Arbabi S, Jurkovich GJ, Wahl WL, Kim HM, Maier RV. Effect of patient load on trauma outcomes in a Level I trauma center. J Trauma 2005;59:815–8. [CrossRef ]

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