Predictors of in-hospital mortality of trauma patients injured in vehicle accidents

Markogiannakis, Haridimos; Sanidas, Elias; Messaris, Evangelos; Koutentakis, Dimitrios; Alpantaki, Kalliopi; Kafetzakis, Alexandros; Tsiftsis, Dimitrios

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Predictors of in-hospital mortality of trauma patients injured in vehicle accidents [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2008; 14(2): 125-131

Predictors of in-hospital mortality of trauma patients injured in vehicle accidents

Haridimos Markogiannakis¹, Elias Sanidas¹, Evangelos Messaris², Dimitrios Koutentakis³, Kalliopi Alpantaki⁴, Alexandros Kafetzakis⁵, Dimitrios Tsiftsis¹
¹Department Of Surgical Oncology, Herakleion University Hospital, Herakleion Medical School, University Of Crete, Herakleion, Crete, Greece
²1st Department Of Propaedeutic Surgery, Hippokrateion Hospital, Athens Medical School, University Of Athens, Athens, Greece
³Department Of Neurosurgery, Herakleion University Hospital, Herakleion Medical School, University Of Crete, Herakleion, Crete, Greece
⁴Department Of Orthopaedics, Herakleion University Hospital, Herakleion Medical School, University Of Crete, Herakleion, Crete, Greece
⁵Department Of Thoracic And Vascular Surgery, Herakleion University Hospital, Herakleion Medical School, University Of Crete, Herakleion, Crete, Greece

OBJECTIVES
Identification and assessment of predictive factors of in-hospital mortality of trauma patients injured in vehicle accidents.
METHODS
We reviewed the Trauma Registry data of Herakleion University Hospital, a level I trauma center in Crete, Greece. All 730 consecutive, adult motor-vehicle trauma patients admitted to our hospital from 1997 to 2000 were included in the study. Variables included in the analysis were: sex, age, mechanism of injury, injuries per anatomic region, initial vital signs, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), and the final outcome. In order to better describe continuous variables, two categories were created: age ≥60 and <60; ISS ≥18 and <18.
RESULTS
Mortality rate was 4.8% (n=35). Multivariate survival analysis showed that age greater than or equal to 60 years (p=0.0002), ISS greater than or equal to 18 (p=0.003), being a pedestrian (p=0.007), craniocerebral injuries (p=0.01), thoracic (p=0.01), and abdominal injuries (p=0.01) are independent predictors of the in-hospital mortality of the patients.
CONCLUSION
Trauma patients after vehicle accidents aged ≥60, pedestrians, those with an ISS ≥18 and craniocerebral, thoracic or abdominal injuries are at higher risk of an in-hospital fatal outcome.

Keywords: In-hospital mortality, predictive factors; trauma patients; vehicle accidents.

Motorlu ara� kazalar�nda yaralanan travma hastalar� ile ilgili hastane mortalitesi tahminleri

Haridimos Markogiannakis¹, Elias Sanidas¹, Evangelos Messaris², Dimitrios Koutentakis³, Kalliopi Alpantaki⁴, Alexandros Kafetzakis⁵, Dimitrios Tsiftsis¹
¹Girit �niversitesi, Herakleion T�p Fak�ltesi, Herakleion �niversite Hastanesi, Cerrahi Onkoloji Klini�i, Girit, Yunanistan
²Atina �niversitesi, Atina T�p Fak�ltesi, Hipokrat Hastanesi, 1. Cerrahiye Giri� Klini�i, Atina, Yunanistan
³Girit �niversitesi, Herakleion T�p Fak�ltesi, Herakleion �niversite Hastanesi, N�ro�ir�rji Klini�i, Herakleion, Girit, Yunanistan
⁴Girit �niversitesi, Herakleion T�p Fak�ltesi, Herakleion �niversite Hastanesi, Ortopedi Ve
⁵Girit �niversitesi, Herakleion T�p Fak�ltesi, Herakleion �niversite Hastanesi, Kalp-damar Cerrahisi Klini�i, Herakleion, Girit, Yunanistan

AMA�
Motorlu ara� kazalar�nda yaralanan travmal� hastalarla ilgili hastane mortalitesi tahminleri de�erlendirildi.
GERE� VE Y�NTEM
Yunanistan��n Girit kentinde 1. basamak travma merkezi olan Herakleion �niversitesi Hastanesi�nin travma kay�tlar� de�erlendirilerek, 1997 ile 2000 y�llar� aras�nda motorlu ara� kazas� nedeniyle yat�r�lan eri�kin 730 travma hastas� ard��k olarak �al��maya dahil edildi. Hastalar�n cinsiyet, ya�, yaralanma mekanizmas�, beher anatomik b�lge ba��na yaralanma, ba�lang�� vital bulgular�, Glasgow Koma Skalas� (GKS), yaralanma ciddiyet skoru (ISS) ve nihai sonu�lar� analiz edildi. Kesintisiz de�i�kenleri daha iyi tan�mlamak i�in iki kategori olu�turuldu: ≥60 ve <60 ya�, ≥18 ve <18 ISS.
BULGULAR
Mortalite oran� %4,8 bulundu (n=35). �ok de�i�kenli sa�kal�m analizi sonu�lar�: ya� ≥60 (p=0,0002), ≥18 ISS (p=0,003), yaya olma durumu (p=0,007), kraniyoserebral yaralanmalarda (p=0,01), torasik (p=0,01) ve abdominal yaralanmalarda (p=0,01), hastalar�n hastane mortalitelerine ili�kin ba��ms�z tahminlerdi.
SONU�
Motorlu ta��t kazalar�nda, ya�� ≥60, yaya olan, ISS ≥18, kranyoserebral, torasik veya kar�n yaralanmas� olan travma hastalar� hastanede hayat�n� kaybetme sonucu bak�m�ndan y�ksek risk alt�ndad�rlar.

Anahtar Kelimeler: Hastanede mortalite, motorlu ta��t kazalar�; tahmin fakt�rleri; travmal� hastalar.

Haridimos Markogiannakis, Elias Sanidas, Evangelos Messaris, Dimitrios Koutentakis, Kalliopi Alpantaki, Alexandros Kafetzakis, Dimitrios Tsiftsis. Predictors of in-hospital mortality of trauma patients injured in vehicle accidents. Ulus Travma Acil Cerrahi Derg. 2008; 14(2): 125-131

Corresponding Author: Haridimos Markogiannakis, Greece
Manuscript Language: English

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