Predictors of Death in Trauma Patients who are Alive on Arrival at Hospital

Lichtveld, Rob A.; Panhuizen, Ivo F.; Smit, Ronald; Holtslag, Herman R.; Werken, Christiaan van der

doi:10.1007/s00068-007-6097-6

Cited by 23 publications

(22 citation statements)

References 25 publications

(7 reference statements)

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“…Analysis of 507 trauma patients in a European emergency department revealed that an increase in every 1 year of age resulted in a 2% increased risk of death. 10 Consistent with our findings, age was a significant predictor of death ( table 1 ). The mean age in the trauma patients who died were 3 years older than the survivor group ( table 1 ).…”

Section: Discussionsupporting

confidence: 90%

“…Instead, head injury is the most significant anatomic region reported that resulted in early mortality from traumatic injuries. 10 11 Patients with pure head injury were excluded from our Trauma Surgery Registry as they were managed solely by the neurosurgical department. However, there was a subset of patients from our registry that had severe traumatic injuries with concurrent head injuries.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic predictors of early mortality from exsanguination in adult trauma: a Malaysian trauma center experience

Huei

Mohamad

Lip

et al. 2017

Trauma Surg Acute Care Open

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BackgroundTrauma mortality due to exsanguination is the second most common cause of death. The objective of this study is to investigate the predictors for early death from exsanguination.MethodsA prognostic study was done to identify predictors of early mortality due to exsanguination. Data were extracted from our Trauma Surgery Registry database of Sultanah Aminah Hospital, Johor Bahru, Malaysia. All patients who were treated from May 1, 2011 to April 31, 2014 by the trauma team were included. Adult trauma patients included from the Trauma Surgery Registry were divided into two groups for analysis: early death from exsanguination and death from non-exsanguination/survivors. Univariate and multivariate analysis was performed to look for significant predictors of death from exsanguination. Variables analyzed were demography, mechanism of injury, organ injury scale, physiological parameters (systolic blood pressure (SBP), respiratory rate, heart rate, temperature), Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), New Injury Severity Score (NISS), Trauma and Injury Severity Score (TRISS) and cause of death.ResultsA total of 2208 patients with an average age of 36 (±16) years were included. Blunt trauma was the majority with 90.5%, followed by penetrating injuries (9.2%). The overall mortality is 239 out of 2208 (10.8%). Seventy-eight patients (32.6%) died due to central nervous system injury, 69 due to sepsis (28.9%) and 58 due to exsanguination (24.3%). After multivariate analysis, age (OR 1.026 (1.009 to 1.044), p=0.002), SBP (OR 0.985 (0.975 to 0.995), p=0.003) and temperature (OR 0.203 (0.076 to 0.543), p=0.001) were found to be the significant physiological parameters. Intra-abdominal injury and NISS were significant anatomic mortality predictors from exsanguination (p<0.001). Patients with intra-abdominal injury had four times higher risk of mortality from exsanguination (OR 3.948 (2.331 to 6.686), p<0.001).DiscussionIn a Malaysian trauma center, age, SBP, core body temperature, intra-abdominal injury and NISS were significant predictors of early death from exsanguination.Level of evidenceII.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Prognostic predictors of early mortality from exsanguination in adult trauma: a Malaysian trauma center experience

Huei

Mohamad

Lip

et al. 2017

Trauma Surg Acute Care Open

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“…Furthermore, a regression analysis conducted by Ay et al 47 . revealed that ISS had significant effects on the mortality of trauma patients; several other studies, as well, have significantly determined increased ISS as an effective factor for mortality in trauma cases 48, 49, 50, 51. However, certain studies reported that ISS is not an independent risk factor in relation to mortality 52, 53.…”

Section: Discussionmentioning

confidence: 99%

A study of mortality risk factors among trauma referrals to trauma center, Shiraz, Iran, 2017

Yadollahi

2019

Chinese Journal of Traumatology

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Purpose Trauma is well known as one of the main causes of death and disability throughout the world. Identifying the risk factors for mortality in trauma patients can significantly improve the quality of care and patient outcomes, as well as reducing mortality rates. Methods In this retrospective cohort study, systematic randomization was used to select 849 patients referred to the main trauma center of south of Iran during a period of six months (February 2017–July 2017); the patients’ case files were evaluated in terms of demographic information, pre- and post-accident conditions, clinical conditions at the time of admission and finally, accident outcomes. A logistic regression model was used to analyze the role of factors affecting mortality among subjects. Results Among subjects, 60.4% were in the age-group of 15–39 years. There was a 10.4% mortality rate among patients and motor-vehicle accidents were the most common mechanism of injury (66.7%). Aging led to increased risk of fatality in this study. For each unit increase in Glasgow coma scale (GCS), risk of death decreased by about 40% (odds ratio ( OR ) = 0.63, 95% confidence interval ( CI ): 0.59–0.67). For each unit increase in injury severe score (ISS), risk of death increased by 10% ( OR = 1.11%, 95% CI : 1.08–1.14) and for each unit increase in trauma revised injury severity score (TRISS), there was 18% decrease in the risk of fatality ( OR = 0.82, 95% CI : 0.71–0.88). Conclusion The most common cause of trauma and the most common cause of death from trauma was traffic accidents. It was also found that an increase in the ISS index increases the risk of death in trauma patients, but the increase in GCS, revised trauma score (RTS) and TRISS indices reduces the risk of death in trauma patients. The TRISS indicator is better predictor of traumatic death than other indicators.

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“…In terms of GCS and ISS, our finding is similar to what was reported by others in multiple trauma patients [ 13 - 15 ]. Age, presence of isolated neurological damage, base excess, and hemoglobin were considered as the risk factors of hospital mortality by Lichtveld et al ., [ 16 ]. In another study by Kuhls et al ., [ 14 ] age and GCS were identified as the greatest risk of death in trauma patients.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Risk Factors with Hospital Mortality in Pedestrian Injured Patients; A Dataset Analysis of a Level-I Trauma Center in Southern Iran

Yadollahi¹,

Rahmanian²,

Jamali³

2018

BEAT

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Objective:To determine the indicators predicting the hospital mortality in pedestrian injured patients admitted to a level I trauma center in Southern Iran. Methods:This case control study was conducted in a Level-I trauma hospital in Shiraz. We selected all survived pedestrians who were admitted in the hospital with duration of admission more than 24 hours in one year from March 2016 to February 2017 as control group and compared with all non-survived pedestrian patients who expired in the hospital according to clinical from March 2012 to February 2017. Multiple logistic regression was performed to identify factors of hospital effect on pedestrian mortality and results expressed by Odds Ratios and their confidence intervals (CI) of 95%. Results:A total of 424 survived pedestrian injured patients were compare to 117 non-survived one. Their mean of survived and non-survived patients were 43.79 ± 19.37 and 56.76 ± 18.55 years respectively of which 361 (66.7%) and 180 (33.3%) were men and women, respectively. We found that the gender does not have any relation with hospital mortality (p=0.275). Followed by, age is in relevance with mortality. Glasgow Coma Scale(GCS), Injury Severity Score (ISS), blood urea nitrogen (BUN), platelet (PLT), potassium (K) and hemoglobin (Hb) are significant factor which are associated with mortality. According to logistic analysis GCS ≤8 (p<0.001), low hemoglobin level <9 (p=0.030), BUN >24 (p<0.001), thrombocytopenia <150,000 (p<0.001), and hypokalemia <3.5 (p=0.01) were independently associated with hospital mortality. Among them, GCS≤8 was 72.237 times more likely to be associated with hospital mortality (OR =72.24, CI95% =23.19- 225.05). Conclusion:The results suggest that GCS score, ISS, hemoglobin level, platelet count, BUN and potassium level might be independent factors associated with hospital mortality in pedestrian injured patients.

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Predictors of Death in Trauma Patients who are Alive on Arrival at Hospital

Cited by 23 publications

References 25 publications

Prognostic predictors of early mortality from exsanguination in adult trauma: a Malaysian trauma center experience

Prognostic predictors of early mortality from exsanguination in adult trauma: a Malaysian trauma center experience

A study of mortality risk factors among trauma referrals to trauma center, Shiraz, Iran, 2017

Analysis of Risk Factors with Hospital Mortality in Pedestrian Injured Patients; A Dataset Analysis of a Level-I Trauma Center in Southern Iran

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