Evaluation of Trauma Patients Followed Up and Treated in Intensive Care Unit: The Sample of İstanbul Province Training and Research Hospital

Arslan, Kadir; Şahin, Ayça Sultan; Yalçın, Naime; Kaya, Emin

doi:10.4274/tybd.galenos.2022.20591

Cited by 5 publications

(5 citation statements)

References 14 publications

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Section: Discussionmentioning

confidence: 99%

“…In addition to trauma-specific scoring systems such as GCS, non-specific scoring systems such as APACHE II are used to determine the prognosis and predict mortality in critically ill patients followed in the ICU [ 21 , 22 ]. It has been stated in the literature that low GCS, high APACHE II scores, and high serum lactate levels can predict mortality in trauma patients [ 22 ]. Arslan et al [ 22 ] reported that serum lactate level is an indicator of tissue perfusion disorder and that high lactate levels are an independent predictor of mortality in trauma patients.…”

Section: Discussionmentioning

confidence: 99%

“…It has been stated in the literature that low GCS, high APACHE II scores, and high serum lactate levels can predict mortality in trauma patients [ 22 ]. Arslan et al [ 22 ] reported that serum lactate level is an indicator of tissue perfusion disorder and that high lactate levels are an independent predictor of mortality in trauma patients. However, serum lactate levels can be affected by many conditions, such as decreased hepatic lactate clearance, sepsis, chronic diseases, decreased kidney function, and thiamine deficiency.…”

Section: Discussionmentioning

confidence: 99%

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Predictive value of prognostic nutritional index on postoperative intensive care requirement and mortality in geriatric hip fracture patients

Arslan

2024

North Clin Istanbul

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OBJECTIVE The incidence of postoperative morbidity and mortality in hip fracture patients is high and is associated with nutritional deficiencies. This study investigated the predictive value of preoperative prognostic nutritional index (PNI) on postoperative intensive care unit (ICU) requirement and mortality in geriatric hip fracture patients. METHODS Geriatric (≥65 years old) hip fracture patients who underwent surgery between January 2021 and September 2023 were evaluated retrospectively. Patients were classified according to the unit followed in the postoperative period (service group and ICU group) and 28-day mortality (mortality group and survivor group). The predictive value of PNI for ICU requirement and mortality and the factors affecting ICU requirement and mortality were investigated. RESULTS The study included two hundred twenty-two patients, and 66.2% (n=147) were women. In the postoperative period, 47.7% (n=106) of the patients were followed in the ICU and 52.3% (n=116) in the inpatient service. The 28-day mortality of the patients was 6.8% (n=15). PNI was found to be significantly lower in patients followed in the ICU (group ICU) than in those followed in the service (group S) and in patients who died (group mortality) compared to those who lived (group survivor) (p<0.001 and p=0.029, respectively). In multivariate regression analysis, high American Society of Anesthesiologists (ASA) status and low PNI were determined to be independent risk factors for ICU requirement. Acute Physiology and Chronic Health Assessment II score was an independent predictor of mortality. In ROC curve analysis, the cut-off value of PNI in predicting mortality was 32.5, and the area under the curve was 0.660 (95% CI, 0.516–0.803). CONCLUSION In geriatric hip fracture patients, preoperative PNI value can be used, like ASA status, in determining postoperative ICU requirements. Nutritional deficiencies are associated with adverse postoperative outcomes in this patient group, and low PNI values (<32.5) help predict in-hospital mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Predictive value of prognostic nutritional index on postoperative intensive care requirement and mortality in geriatric hip fracture patients

Arslan

2024

North Clin Istanbul

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Section: Discussionmentioning

confidence: 99%

“…GCS score can predict prognosis in trauma patients followed in ICU. [24,25] It has been found that the prognostic role of NLR levels in predicting adverse outcomes in patients with severe TBI is similar to GCS. [25] Our study found that GCS scores were significantly lower in the mortality group, consistent with the AUC = area under curve, CI = confidence interval (minimum-maximum), NLR = neutrophil-tolymphocyte ratio, PLR = platelet-to-lymphocyte ratio, SII = systemic immune-inflammation index.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of systemic immune-inflammation index, neutrophil-lymphocyte ratio, and thrombocyte-lymphocyte ratio in critically ill patients with moderate to severe traumatic brain injury

Arslan,

Sahin

2024

Medicine

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Traumatic brain injury (TBI) is a significant health problem with a high mortality rate. Inflammatory markers can predict the prognosis of TBI where neuroinflammation is essential. In this study, the prognostic value of the systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) at admission in patients with critical TBI was investigated. Patients with moderately severe TBI in the intensive care unit (ICU) of a tertiary center between June 2020 and June 2022 were retrospectively reviewed. Patients were classified into survivor and mortality groups. The predictive performance of SII, PLR, and NLR levels calculated from blood results at admission and 28-day mortality and patient outcomes were analyzed. One hundred sixty-one patients were included in this study. The median age of the entire population was 41 (18–90) years, and 80.7% (n = 130) of the patients were male. Falls (42.2%) and traffic accidents (40.4%) were the most common causes of TBI. The most common primary diagnoses in patients with TBI were acute subdural hematoma (30.4%) and subarachnoid hemorrhage (26.1%). The SII and NLR levels were significantly higher in the mortality group, and PLR levels were significantly lower (P = .004, P < .001, P < .001, respectively). In multivariate regression analysis, SII and PLR were independent predictors of mortality (P = .031 and P < .001, respectively). In the receiver operating characteristics (ROC) curve analysis, the cutoff value for SII was ≥ 2951, and the area under the curve (AUC) was 0.662 (95% CI, 0.540–0.784). The cutoff value for NLR was ≥ 9.85, AUC was 0.717 (95% CI, 0.600–0.834), and the cutoff value for PLR was ≤ 130.4, AUC was 0.871 (95% CI, 0.796–0.947). 28-day mortality was 21.1%. Neuroinflammation is essential in patients with critical TBI, and inflammatory markers SII, NLR, and PLR have prognostic importance. SII and PLR are independent predictors of mortality. Early detection of those with a poor prognosis in critically ill TBI patients and planning aggressive treatments may contribute to reducing mortality.

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Lactate, lactate clearance, and lactate-to-albumin ratio in predicting mortality in patients with critical polytrauma: A retrospective observational study

Arslan,

Sultan Sahin

2024

Medicine

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Lactate is a product of anaerobic metabolism used to determine prognosis in critically ill trauma patients. This study investigates the mortality-predictive performance of lactate, lactate clearance, and lactate-to-albumin ratio (LAR) on admission in patients with polytrauma in a tertiary center’s intensive care unit (ICU). Polytrauma patients in the ICU between June 2019 and June 2022 were evaluated. The diagnosis of polytrauma was made according to the Berlin criteria, a widely accepted and comprehensive system for classifying the severity of multiple injuries. Patients were classified into survivor and mortality groups. The predictive performance of lactate, lactate clearance (24th hour), and LAR for 28-day mortality was compared. The study included 176 patients. The median age of the entire population was 35 (24–50) years, and 78.4% (n = 138) were male. Motor vehicle accidents were the most common cause of polytrauma in patients (48.9%, n = 86). The most common head injuries were detected in the patients (59.1%, n = 104). In the mortality group, median lactate and lactate (24th hour) levels were significantly higher (P < .001). Median albumin and LAR values were significantly lower (P < .001). Although 24-hour lactate clearance was lower in the mortality group, no significant difference was detected (36.1% vs 42.3%, P = .052). In multivariate regression analysis, LAR was an independent predictor of mortality (P < .001). In receiver operating characteristics curve analysis, the cutoff value of lactate was ≥5.4, the area under the curve (AUC) was 0.75 (95% confidence interval [CI], 0.66–0.84), the cutoff value of lactate clearance was ≤39.2, AUC was 0.60, (95% CI, 0.51–0.69), and the cutoff value of LAR was value ≥1.50, AUC 0.83 (95% CI, 0.75–0.90). In critically ill polytrauma patients, LAR on ICU admission is an independent predictor of mortality and has acceptable prognostic value. LAR is superior to lactate and 24-hour lactate clearance in predicting mortality.

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Evaluation of Trauma Patients Followed Up and Treated in Intensive Care Unit: The Sample of İstanbul Province Training and Research Hospital

Cited by 5 publications

References 14 publications

Predictive value of prognostic nutritional index on postoperative intensive care requirement and mortality in geriatric hip fracture patients

Predictive value of prognostic nutritional index on postoperative intensive care requirement and mortality in geriatric hip fracture patients

Prognostic value of systemic immune-inflammation index, neutrophil-lymphocyte ratio, and thrombocyte-lymphocyte ratio in critically ill patients with moderate to severe traumatic brain injury

Lactate, lactate clearance, and lactate-to-albumin ratio in predicting mortality in patients with critical polytrauma: A retrospective observational study

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