Independent Predictors of Mortality in Torso Trauma Injuries
Abstract
:1. Introduction
2. Materials and Methods
3. Results
Analysis of Non-Survivors
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variables | Total (n = 777) | Survivors (n = 650) | Non-Survivors (n = 127) | p | |||
---|---|---|---|---|---|---|---|
Value | % | Value | % | Value | % | ||
Age (median/IQR) | 43 | 30–59 | 42 | 28–57 | 56 | 38–56 | <0.001 * |
Gender (male) | 536 | 69 | 446 | 68.6 | 90 | 70.9 | 0.675 |
Triage code (Red) | 335 | 43.1 | 317 | 48.8 | 18 | 14.2 | <0.001 * |
Type of trauma (blunt) | 706 | 90.9 | 585 | 90 | 121 | 95.3 | 0.064 |
Mechanism of trauma | 0.014 * | ||||||
Multivehicle crash | 109 | 14 | 93 | 14.3 | 16 | 12.6 | |
Motorcycle crash | 224 | 28.8 | 198 | 30.5 | 226 | 20.5 | |
Cyclist | 44 | 5.7 | 33 | 5.1 | 11 | 8.7 | |
Pedestrian | 120 | 15.4 | 98 | 15.1 | 22 | 17.3 | |
Fall | 186 | 23.9 | 142 | 21.8 | 44 | 34.6 | |
Crush | 18 | 2.3 | 17 | 2.6 | 1 | 0.8 | |
Gunshot wound | 11 | 1.4 | 11 | 1.7 | 0 | 0 | |
Stab wound | 55 | 7.1 | 49 | 7.5 | 6 | 4.7 | |
Pre-hospital GCS (median/IQR) | 15 | 11–15 | 15 | 14–15 | 6 | 3–6 | <0.001 * |
Pre-hospital SBP (median/IQR) | 110 | 90–130 | 120 | 96-130 | 82 | 55-82 | <0.001 * |
Pre-hospital HR (median/IQR) | 96 | 80–115 | 96 | 80–110 | 100 | 63–95 | 0.217 |
Pre-injury ASA-PS > 1 | 45 | 5.8 | 29 | 4.5 | 16 | 12.8 | 0.001 * |
Pre-hospital OTI/LMA | <0.001 * | ||||||
Not intubated | 461 | 61.6 | 426 | 68.5 | 35 | 27.8 | |
Drug assisted | 260 | 34.8 | 193 | 31 | 67 | 53.2 | |
Non drug assisted | 27 | 3.6 | 3 | 0.5 | 24 | 19 | |
AIS 98’ ≥ 3 | |||||||
Head | 250 | 32.2 | 178 | 27.4 | 72 | 56.7 | <0.001 * |
Chest | 600 | 77.2 | 492 | 75.7 | 108 | 85 | 0.021 * |
Abdomen | 330 | 42.5 | 278 | 42.8 | 52 | 40.9 | 0.769 |
Pelvis | 359 | 46.2 | 291 | 44.8 | 68 | 53.5 | 0.08 |
Extremities | 185 | 23.8 | 150 | 23.1 | 35 | 27.6 | 0.305 |
Variables | Total (n = 777) | Survivors (n = 650) | Non-Survivors (n = 127) | p | |||
---|---|---|---|---|---|---|---|
Value | % | Value | % | Value | % | ||
ED GCS (median/IQR) | 14 | 3–15 | 15 | 3–15 | 3 | 3–3 | <0.001 * |
ED SBP (mean/SD) | 45 | 19.82 | 119 | 28.86 | 80 | 46.13 | <0.001 * |
ED HR (median/IQR) | 95 | 80–110 | 95 | 80–110 | 95 | 70–95 | 0.772 |
Hemodynamic instability | 166 | 21.4 | 97 | 14.9 | 69 | 54.3 | <0.001 * |
E-FAST | 0.966 | ||||||
Negative | 416 | 53,5 | 347 | 53.4 | 69 | 54.3 | |
Positive | 320 | 41.2 | 268 | 41.2 | 52 | 40.9 | |
Not performed | 40 | 5.3 | 35 | 5.4 | 6 | 4.8 | |
Torso CeCT scan (performed) | 679 | 87.4 | 591 | 90.9 | 88 | 69.3 | <0.001 * |
Chest tube | 0.003 * | ||||||
None | 434 | 55.9 | 369 | 56.8 | 65 | 51.2 | |
Unilateral | 267 | 34.4 | 228 | 35.1 | 39 | 30.7 | |
Bilateral | 76 | 9.8 | 53 | 8.2 | 23 | 18.1 | |
DCL | 172 | 22.1 | 133 | 20.5 | 39 | 30.7 | 0.014 * |
EDT | 7 | 0.9 | 0 | 0 | 7 | 5.5 | <0.001 * |
EPP | 86 | 11.1 | 48 | 7.4 | 38 | 29.9 | <0.001* |
Angiography/embolization | 182 | 23.4 | 157 | 24.2 | 25 | 19.7 | 0.304 |
BE (median/IQR) | −4 | −7/−1 | −3 | −6/−1 | −8 | −15/−8 | <0.001 * |
INR (median/IQR) | 1 | 1–1 | 1 | 1–1 | 2 | 1–2 | <0.001 * |
Lactate (median/IQR) | 3 | 2–5 | 3 | 2–4 | 7 | 4–7 | <0.001 * |
ISS (median/IQR) | 29 | 21–41 | 29 | 20–38 | 45 | 35–44 | <0.001 * |
Probability of death (TRISS) | 9 | 3–35 | 6 | 2–20 | 85 | 37–85 | <0.001 * |
Massive transfusion protocol activation | 214 | 27.5 | 181 | 27.8 | 33 | 26 | 0.745 |
PRBCs (median/IQR) | 8 | 5–12 | 8 | 5–12 | 9 | 5–9 | 0.84 |
FFP (median/IQR) | 5 | 4–10 | 5 | 4–9 | 5 | 2–5 | 0.409 |
PP (median/IQR) | 1 | 0–2 | 1 | 0–2 | 1 | 0–1 | 0.847 |
Variables | p Univariate | p Multivariate | Adjusted OR | 95% CI | |
---|---|---|---|---|---|
Lower | Upper | ||||
Age | <0.001 * | <0.001 * | 1.064 | 1.045 | 1.083 |
Pre-hospital GCS | <0.001 * | <0.001 * | 0.831 | 0.771 | 0.896 |
Pre-hospital SBP | <0.001 * | 0.03 * | 0.989 | 0.980 | 0.999 |
Pre-injury ASA-PS (2–3) | <0.001 * | ||||
Pre-hospital OTI /LMA | <0.001 * | ||||
Head AIS ≥ 3 | <0.001 * | ||||
Chest AIS ≥ 3 | 0.023 * | ||||
ED GCS | <0.001 * | ||||
ED SBP | <0.001 * | 0.039 * | 0.989 | 0.979 | 0.999 |
Torso CeCT scan (performed) | <0.001 * | 0.029 * | 0.270 | 0.083 | 0.874 |
Chest tube | 0.017 * | ||||
DCL | 0.012 * | ||||
EDT | N.S. | ||||
EPP | <0.001 * | ||||
BE | <0.001 * | 0.008 * | 0.931 | 0.883 | 0.982 |
INR | <0.001 * | 0.054 | 1.382 | 0.994 | 1.922 |
Lactate | N.S. | ||||
ISS | <0.001 * | <0.001 * | 1.050 | 1.026 | 1.075 |
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Bini, R.; Accardo, C.; Granieri, S.; Sammartano, F.; Cimbanassi, S.; Renzi, F.; Bindi, F.; Briani, L.; Chiara, O. Independent Predictors of Mortality in Torso Trauma Injuries. J. Clin. Med. 2020, 9, 3202. https://doi.org/10.3390/jcm9103202
Bini R, Accardo C, Granieri S, Sammartano F, Cimbanassi S, Renzi F, Bindi F, Briani L, Chiara O. Independent Predictors of Mortality in Torso Trauma Injuries. Journal of Clinical Medicine. 2020; 9(10):3202. https://doi.org/10.3390/jcm9103202
Chicago/Turabian StyleBini, Roberto, Caterina Accardo, Stefano Granieri, Fabrizio Sammartano, Stefania Cimbanassi, Federica Renzi, Francesca Bindi, Laura Briani, and Osvaldo Chiara. 2020. "Independent Predictors of Mortality in Torso Trauma Injuries" Journal of Clinical Medicine 9, no. 10: 3202. https://doi.org/10.3390/jcm9103202