A predictive model of early mortality in trauma patients
| Autor: | David A. Hampton, Tim H. Lee, Martin A. Schreiber, Sean P. McCully, Brian S. Diggs |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty Antifibrinolytic medicine.drug_class Vital signs Poison control Logistic regression Risk Assessment Decision Support Techniques Internal medicine Injury prevention medicine Humans Prospective Studies business.industry Glasgow Coma Scale General Medicine Middle Aged Prognosis Thrombelastography Surgery Logistic Models ROC Curve Mann–Whitney U test Wounds and Injuries Observational study business |
| Zdroj: | The American Journal of Surgery. 207:642-647 |
| ISSN: | 0002-9610 |
| Popis: | Rapid thrombelastography (rTEG) is a real-time whole-blood viscoelastic coagulation assay. We hypothesized that admission rTEG and clinical data are independent predictors of trauma-related mortality.Prospective observational data (patient demographics, admission vital signs, laboratory studies, and injury characteristics) from trauma patients enrolled within 6 hours of injury were collected. Mann-Whitney U test and analysis of variance test assessed significance (P ≤ .05). Logistic regression analyses determined the association of the studied variables with 24-hour mortality.Seven hundred ninety-five trauma patients were enrolled, of which 55 died within 24 hours of admission. Admission variables which independently predicted 24-hour mortality were as follows: Glasgow Coma Scale ≤8, hemoglobin11 g/dL, international normalized ratio1.5, Ly308%, and penetrating injury (P.05). This 5-variable model's area under the receiver operator characteristic curve was .88. The Hosmer-Lemeshow goodness-of-fit test was .90.This 5-variable model provides a rapid prediction of 24-hour mortality. The inclusion of rTEG Ly30 demonstrates the association of fibrinolysis with outcome and may support the early use of antifibrinolytic therapies. |
| Databáze: | OpenAIRE |
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