Evaluation of Missing Prehospital Physiological Values in Injured Children and Adolescents.

Autor: Sullivan TM; Division of Trauma and Burn Surgery, Children's National Hospital, Washington, District of Columbia., Milestone ZP; Division of Trauma and Burn Surgery, Children's National Hospital, Washington, District of Columbia., Colson CD; Division of Trauma and Burn Surgery, Children's National Hospital, Washington, District of Columbia., Tempel PE; Division of Trauma and Burn Surgery, Children's National Hospital, Washington, District of Columbia., Gestrich-Thompson WV; Division of Trauma and Burn Surgery, Children's National Hospital, Washington, District of Columbia., Burd RS; Division of Trauma and Burn Surgery, Children's National Hospital, Washington, District of Columbia. Electronic address: rburd@cnmc.org.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2023 Mar; Vol. 283, pp. 305-312. Date of Electronic Publication: 2022 Nov 21.
DOI: 10.1016/j.jss.2022.10.033
Abstrakt: Introduction: Prehospital vital signs and the Glasgow Coma Scale score are often missing in clinical practice and not recorded in trauma databases. Our study aimed to identify factors associated with missing prehospital physiological values, including systolic blood pressure, heart rate, respiratory rate, peripheral oxygen saturation, and Glasgow Coma Scale.
Methods: We used our hospital trauma registry to obtain patient, injury, resuscitation, and transportation characteristics for injured children and adolescents (age <15 y). We evaluated the association of missing documentation of prehospital values with other patient, injury, transportation, and resuscitation characteristics using multivariable regression. We standardized vital sign values using age-adjusted z-scores.
Results: The odds of a missing physiological value decreased with age (odds ratio [OR] = 0.9, 95% confidence interval [CI] = 0.9, 0.9) and were higher when prehospital cardiopulmonary resuscitation was required (OR = 3.3, 95% CI = 1.9, 5.7). Among the physiological values considered, we observed the highest odds of missingness of systolic blood pressure, respiratory rate, and oxygen saturation. The odds of observing normal emergency department physiological values were lower when prehospital physiological values were missing (OR = 0.9, 95% CI = 0.9, 1.0; P = 0.04).
Conclusions: Missing prehospital physiological values were associated with younger age and cardiopulmonary resuscitation among the injured children treated at our hospital. Measurement and documentation of physiological variables of patients with these characteristics should be targeted.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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