Travmatik beyin hasarý olan hastalarda hastane öncesi Ulusal Erken Uyarý Skoru ile hastane içi mortalite arasýndaki iliþki

AMAÇ: Bu çalýþma, travmatik beyin hasarý (TBH) sonuçlarý ile hastane öncesi Ulusal Erken Uyarý Skoru (NEWS), Yaralanma Þiddet Skoru (ISS) ve Revize Travma Skoru (RTS) arasýndaki iliþkiyi incelemeyi amaçlamýþtýr.
GEREÇ VE YÖNTEM: Bu geriye dönük gözlemsel çalýþma, Ocak 2019 ile Aralýk 2020 arasýnda hastane öncesi acil saðlýk hizmetleri sistemine baþvu-ran TBH’li yetiþkin hastalarý içermektedir. Kýsaltýlmýþ Yaralanma Skalasý Puaný 3 veya daha yüksek olduðunda TBH kabul edildi. Primer sonuç, hastane içi mortalite idi.
BULGULAR: Çalýþmaya alýnan 248 hasta arasýnda hastane içi mortalite %18.5 (n=46) olarak bulundu. Hastane içi mortaliteyi öngörmeye yönelik çok deðiþkenli analizde, hastane öncesi NEWS (Odss ratio, 1.198; %95 güven aralýðý [CI], 1.042–1.378) ve RTS (OR, 0.568; %95 CI, 0.422–0.766) hastane içi mortaliteyle baðýmsýz olarak iliþkiliydi. ISS, RTS ve hastane öncesi NEWS için eðrinin altýndaki alan (AUC’ler) sýrasýyla 0.731 (%95 CI, 0.672–0.786), 0,853 (%95 CI, 0.802–0.894) ve 0.843 (%95 CI, 0.791–0.886) idi. Hastane öncesi NEWS’in AUC’si, ISS’ninkinden önemli oranda farklýydý, ancak RTS’ninkinden farklý deðildi.
TARTIÞMA: Hastane öncesi NEWS, sahada TBH’li hastalarýn hýzlý bir þekilde sýnýflandýrýlmasýna ve uygun hastanelere nakledilmesine yardýmcý olarak prognozun iyileþtirilmesine katkýda bulunabilir.

Association between pre-hospital National Early Warning Score and in-hospital mortality in patients with traumatic brain injury

BACKGROUND: This study aimed to examine the association between the outcome of traumatic brain injury (TBI) and pre-hospital National Early Warning Score (NEWS), Injury Severity Score (ISS), and Revised Trauma Score (RTS).
METHODS: This retrospective and observational study included adult patients with TBI admitted to the pre-hospital emergency medical services system between January 2019 and December 2020. TBI was considered when the abbreviated injury scale score was 3 or higher. The primary outcome was in-hospital mortality.
RESULTS: Among 248 patients included in the study, in-hospital mortality was 18.5% (n=46). In the multivariate analysis for predict-ing in-hospital mortality, pre-hospital NEWS (Odds ratio [OR], 1.198; 95% Confidence interval [CI], 1.042–1.378) and RTS (OR, 0.568; 95% CI, 0.422–0.766) were independently associated with in-hospital mortality. The area under the curves (AUCs) for ISS, RTS, and pre-hospital NEWS were 0.731 (95% CI, 0.672–0.786), 0.853 (95% CI, 0.802–0.894), and 0.843 (95% CI, 0.791–0.886), respectively. The AUC of pre-hospital NEWS was significantly different from that of ISS but not from that of RTS.
CONCLUSION: Pre-hospital NEWS could contribute to improving prognosis by aiding in the rapid classification of patients with TBI in the field and their transportation to appropriate hospitals.