The NACA score predicts mortality in polytrauma patients before hospital admission: a registry-based study.

Autor: Fiore PI; Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Via Tesserete 46, 6900, Lugano, Switzerland., Monteleone AS; Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Via Tesserete 46, 6900, Lugano, Switzerland. andreastefano.monteleone@gmail.com., Müller J; Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Via Tesserete 46, 6900, Lugano, Switzerland.; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland., Filardo G; Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Via Tesserete 46, 6900, Lugano, Switzerland.; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland., Candrian C; Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Via Tesserete 46, 6900, Lugano, Switzerland.; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland., Riegger M; Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Via Tesserete 46, 6900, Lugano, Switzerland.; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.
Jazyk: angličtina
Zdroj: Scandinavian journal of trauma, resuscitation and emergency medicine [Scand J Trauma Resusc Emerg Med] 2024 Nov 18; Vol. 32 (1), pp. 116. Date of Electronic Publication: 2024 Nov 18.
DOI: 10.1186/s13049-024-01281-3
Abstrakt: Background: The early assessment of the severity of polytrauma patients is key for their optimal management. The aim of this study was to investigate the discriminative performance of the NACA score in a large dataset by stratifying the severity of polytraumatized patients in correlation to injury severity score (ISS), Glasgow Coma Scale (GCS), and mortality.
Methods: This study on the Swiss Trauma Registry investigated 2239 polytraumatized patient (54.3 ± 22.8 years) enrolled from 2015 to 2023: 0.5% were NACA 3, 76.7% NACA 4, 21.4% NACA 5, and 1.4% NACA 6. The NACA predictive value of patients' mortality was investigated, as well as the correlation of ISS and GCS scores, and other factors influencing patients' survival at discharge and after 28 days.
Results: In NACA 4 and 5 the survival rate during hospitalization was 97.7% and 82.5%, respectively, and 28-day mortality 3.5% and 23.5%, respectively (p < 0.0005). NACA correlated with GCS in the prehospital phase and in the emergency room (p < 0.0005), as well as with ISS (p < 0.0005). NACA 4 and 5 presented different injury patterns (fall < 3 m vs vehicle accident) with NACA 5 requiring more CPR and intubation (p < 0.001, p < 0.0005). The ROC AUC analysis showed the prehospital NACA and GCS values as the strongest variables predicting patients' survival.
Conclusions: This study provides valuable evidence supporting the effectiveness of the NACA score in assessing the severity of polytrauma patients in both the pre-ER and ER condition. Considering the statistical significant correlation with the GCS and with the ISS, NACA is a valid score for assessing polytrauma patients.
Competing Interests: Declarations Ethics approval and consent to participate The study protocol was approved by the local cantonal ethics committee of the Canton of Tessin, Switzerland (prot 2024-00236 CE 4536). Consent for publication Not applicable. Competing interests The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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