Determining Outcomes in Nonpenetrating Trauma With qSOFA.

Autor: Merida JR; Renaissance School of Medicine, Stony Brook, New York., Sanchez E; Renaissance School of Medicine, Stony Brook, New York., Mukhi A; Division of Trauma, Department of Surgery, Stony Brook University Hospital, Stony Brook, New York., Naeem Z; Division of Trauma, Department of Surgery, Stony Brook University Hospital, Stony Brook, New York., Eckardt P; Department of Surgery, Good Samaritan Hospital, West Islip, New York., Fasanya C; Department of Surgery, Good Samaritan Hospital, West Islip, New York., Vosswinkel J; Division of Trauma, Department of Surgery, Stony Brook University Hospital, Stony Brook, New York., Hsieh H; Division of Pediatric Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, New York., Jawa RS; Division of Trauma, Department of Surgery, Stony Brook University Hospital, Stony Brook, New York. Electronic address: Randeep.Jawa@stonybrookmedicine.edu.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2024 Sep; Vol. 301, pp. 647-655. Date of Electronic Publication: 2024 Aug 07.
DOI: 10.1016/j.jss.2024.07.029
Abstrakt: Introduction: The quick Sequential Organ Failure Assessment (qSOFA) score identifies patients with suspected infection at high risk for adverse outcomes. The qSOFA score is the sum of three variables (respiratory rate, systolic blood pressure, and Glasgow Coma Score) with binary thresholds. The role of qSOFA in predicting hospitalization outcomes in nonpenetrating trauma patients was determined at a level 1 and a level 2 trauma center.
Methods: The trauma registries at the two institutions were queried for adult (18+ y) and pediatric (0-17 y) nonpenetrating trauma hospitalizations between January 1, 2019 and September 30, 2021.
Results: At institution A, there were 3720 adult hospitalizations (qSOFA = 0: 2906 patients, qSOFA = 1: 677, qSOFA = 2: 124, qSOFA = 3: 13) and 418 pediatric hospitalizations (qSOFA = 0: 238 patients, qSOFA = 1: 159, qSOFA = 2: 20, qSOFA = 3: 1). At institution B, there were 3579 adult hospitalizations (qSOFA = 0: 2638 patients, qSOFA = 1: 816, qSOFA = 2: 121, qSOFA = 3: 4) and 429 pediatric hospitalizations (qSOFA = 0: 273 patients, qSOFA = 1: 149, qSOFA = 2: 6, qSOFA = 3: 1). In adults at both institutions, increased qSOFA was significantly associated with higher mortality rates. Intensive care unit (ICU) admission increased at institution A and increased at institution B to qSOFA = 2. In multivariable analyses, qSOFA predicted ICU admission and mortality. Pediatric patients had low injury severity, morbidity, and mortality. Excluding the one early qSOFA = 3 mortality, higher qSOFA scores were associated with increased ICU admission in pediatric patients.
Conclusions: Elevated qSOFA scores are associated with ICU admission and mortality in adult nonpenetrating trauma patients. Further investigation on qSOFA for resource allocation is indicated.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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