Prognostic value of Sequential Organ Failure Assessment and Simplified Acute Physiology II score compared with trauma scores in the outcome of multiple-trauma patients

Fueglistaler, Philipp; Amsler, Felix; Schüepp, M; Fueglistaler-Montali, Ida; Attenberger, Corinna; Pargger, Hans; Jacob, Augustinus Ludwig; Groß, Thomas

doi:10.1016/j.amjsurg.2009.08.035

Cited by 33 publications

(41 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, our aim was to determine the link between adverse events and BSI management and the statistical analysis demonstrated that they were related to the polytrauma severity in all groups. We used the SAPS2, frequently used in Europe and showing performance as good as the ISS in assessing polytrauma patients (35). These two scores, reflecting the severity of polytrauma, were strongly related to adverse event occurrence but we had many missing ISS scores, limiting the statistical analysis of this parameter.…”

Section: Discussionmentioning

confidence: 99%

Blunt splenic injury: are early adverse events related to trauma, nonoperative management, or surgery?

Frandon¹,

Rodière²,

Arvieux³

et al. 2015

Diagn Interv Radiol

View full text Add to dashboard Cite

B lunt splenic injury (BSI) has become more frequently managed nonoperatively over the years, with the results improved by the contribution of embolization, making it possible to treat active hemorrhages as well as prevent hemorrhages in high-grade trauma of the spleen without active bleeding (1-10). Three methods of splenic artery injury management can be defined: operative management (OM), nonoperative management (NOM), and nonoperative management with splenic artery embolization (SAE).The complication rate in relation to different management methods (operative and nonoperative) continues to be debated. The description and prevalence of these complications varies greatly from one series to another (7,(11)(12)(13), resulting from the confusion existing between adverse events related to injury and those related to treatment. The severity of polytrauma is taken into account using the patients' injury severity score (ISS), and several studies have shown that a high ISS was related to more nonsurgical treatment failures (14). Certain authors have taken a specific interest in the parameters of multiple injuries and shown that lesions of associated organs (pancreas, spinal cord, limbs) were related to more complications (15-17). The severity of trauma and associated lesions could therefore be considered confounding factors resulting in treatment failure and complications. A better understanding of these complications could help in preventing them.The objectives of this study were to compare outcomes of the three types of BSI management, determine if there are any complications statistically related to management methods, and demonstrate risk factors taking polytrauma into account. We focused on associated injuries and early adverse events. Multivariate analysis was performed on 23 prognostic factors to find predictors. RESULTSThe total survival rate was 97.1%, with four deaths all occurred in the OM group. The spleen salvage rate was 91% in NOM and SAE. At least one adverse event was observed in 32.8%, 62%, and 96% of patients in NOM, SAE, and OM groups, respectively (P < 0.001). We found significantly more deaths, infectious complications, pleural drainage, acute renal failures, and pancreatitis in OM and more pseudocysts in SAE. Six prognostic factors were statistically significant for one or more adverse events: simplified acute physiology score 2 ≥25 for almost all adverse events, age ≥50 years for acute respiratory syndrome, limb fracture for secondary bleeding, thoracic injury for pleural drainage, and at least one associated injury for pseudocyst. Adverse events were not related to the type of BSI management. CONCLUSIONPatients with BSI present worse outcome and more adverse events in OM, but this is related to the severity of injury. The main predictor of adverse events remains the severity of injury.

show abstract

Section: Discussionmentioning

confidence: 99%

Blunt splenic injury: are early adverse events related to trauma, nonoperative management, or surgery?

Frandon¹,

Rodière²,

Arvieux³

et al. 2015

Diagn Interv Radiol

View full text Add to dashboard Cite

show abstract

“…Quanto ao gênero, a predominância de indivíduos do sexo masculino (82,0%) nas vítimas de trauma em UTI corrobora com achados de outros estudos que analisaram este tipo de paciente (77,(80)(81)85,88,96,(113)(114)(115) . Entretanto, em pesquisas nacionais (47,52,57,(110)(111)116) e internacionais (107)(108)(109) que analisaram populações gerais, não é observada tal discrepância da frequência de homens perante o sexo oposto na UTI.…”

Section: Discussionunclassified

“…A maioria dos estudos que analisam especificamente vítimas de trauma admitidas em UTI aplica os índices APACHE II e SAPS II nesta população, com o objetivo de avaliar a capacidade discriminatória do índice em estimar a mortalidade (74)(75)(76)(77)(78)(79)(80)(81) , identificar a performance de índices de gravidade do paciente de UTI combinados a indicadores de gravidade do trauma na predição de mortalidade (74,(81)(82) , realizar análise comparativa entre os grupos de sobreviventes e não sobreviventes (74,79,(83)(84) ou daqueles que apresentaram sepse grave (85) , fibrilação atrial (86) , lesão pulmonar aguda (85,87) , falência múltipla de órgãos (85,88) ou infecção nosocomial (89) .…”

Section: Miranda E Colaboradores Autores Do Tiss-28 Publicaram Em 1unclassified

“…A caracterização da população do estudo que comparou a performance de índices fisiológicos e anatômicos, bem como a combinação deles, revelou que as vítimas admitidas na UTI apresentaram média de 2,53 (±1,58) lesões AIS igual a 3 (81) , valor próximo ao encontrado nesta pesquisa (3,1±1,8).…”

Section: Esses Achados Reforçam Que O Trauma é Uma Doença Cirúrgica Eunclassified

“…Dos 200 pacientes analisados, 38 morreram durante a permanência na UTI, representando uma taxa de mortalidade de 19,0%, valor considerado superior quando comparado a diferentes estudos que analisaram desfechos em vítimas de trauma na unidade crítica (74,77,81,103,114) . (109) .…”

Section: Esses Achados Reforçam Que O Trauma é Uma Doença Cirúrgica Eunclassified

See 2 more Smart Citations

Vítimas de trauma admitidas em unidade de terapia intensiva: características e fatores associados à carga de trabalho de enfermagem

Nogueira¹

View full text Add to dashboard Cite

Langzeitoutcome nach Polytrauma im erwerbsfähigen Alter

Groß

Amsler

2015

Unfallchirurg

View full text Add to dashboard Cite

show abstract

Prognostic value of Sequential Organ Failure Assessment and Simplified Acute Physiology II score compared with trauma scores in the outcome of multiple-trauma patients

Cited by 33 publications

References 52 publications

Blunt splenic injury: are early adverse events related to trauma, nonoperative management, or surgery?

Blunt splenic injury: are early adverse events related to trauma, nonoperative management, or surgery?

Vítimas de trauma admitidas em unidade de terapia intensiva: características e fatores associados à carga de trabalho de enfermagem

Langzeitoutcome nach Polytrauma im erwerbsfähigen Alter

Contact Info

Product

Resources

About