Ulus Travma Acil Cerrahi Derg. 2018; 24(6): 532-538 | DOI: 10.5505/tjtes.2018.29434

Factors predicting the early mortality of trauma patients

Won Young Yong Jin¹, Jin Hee Jeong¹, Dong Hoon Kim¹, Tae Yun Kim¹, Changwoo Kang¹, Soo Hoon Lee¹, Sang Bong Lee¹, Seong Chun Kim³, Yong Joo Park³, Daesung Lim^3
1Department of Emergency Medicine,Gyeongsang National University School of Medicine, Jinju-si, Gyeongsangnam-do-Republic of Korea
²Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju-si, Gyeongsangnam-do-Republic of Korea
³Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Gyeongsangnam-Republic of Korea

BACKGROUND: The aim of this study was to identify factors predicting early mortality in trauma patients.
METHODS: This was a study of 6288 trauma patients admitted to the hospital between July 2011 and June 2016. Among the variables recorded for a prospective trauma registry, the following were selected for analysis: sex; age; a combination of the Glasgow Coma Scale score, age, and systolic blood pressure (SBP) (GAP); a combination of the mechanism of injury, the Glasgow Coma Scale score, age, and SBP (MGAP); SBP; respiratory rate; peripheral oxygen saturation (SpO2 value); the Glasgow Coma Scale score; laboratory variables; and presentation time. Logistic regression analysis was used to explore associations between these variables and early mortality.
RESULTS: In total, 296 (4.6%) patients died within 24 hours. Univariate regression analysis indicated that age, the GAP, the MGAP, SBP, SpO2, the Glasgow Coma Scale score, base excess, hemoglobin level, platelet count, INR, and presentation time predicted early mortality. Multivariate regression showed that the GAP, the MGAP, SpO2, base excess, platelet count, and INR were independently predictive. The areas under the receiver operator curve comparisons for the GAP and MGAP models revealed the superiority of the GAP-based model.
CONCLUSION: The GAP model, SpO2, base excess, platelet count, and INR predicted the early mortality of trauma patients.

Keywords: Acute traumatic coagulopathy, base excess, mortality; peripheral oxygen saturation; trauma; trauma scoring system

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