Comparisons of Trauma Outcomes and Injury Severity Score
| Autor: | Susan J. Appel, Donna Grisham, Sarah Dunlap, Lisa B Elgin |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Vital signs Emergency Nursing Critical Care Nursing Logistic regression Young Adult 03 medical and health sciences Injury Severity Score Mississippi 0302 clinical medicine Cause of Death Humans Medicine Registries Young adult Aged Cause of death Aged 80 and over Advanced and Specialized Nursing 030504 nursing Multiple Trauma business.industry 030208 emergency & critical care medicine Odds ratio Middle Aged Logistic Models Blood pressure Shock (circulatory) Emergency medicine Female medicine.symptom 0305 other medical science business human activities |
| Zdroj: | Journal of Trauma Nursing. 26:199-207 |
| ISSN: | 1078-7496 |
| DOI: | 10.1097/jtn.0000000000000449 |
| Popis: | Trauma is a global health problem and a leading cause of mortality. One of the major predictors of trauma mortality is the Injury Severity Score (ISS). Theoretically, as the ISS increases, the probability of survival decreases; ISS = 75 is considered to be not survivable. Studies have shown that some deaths are preventable and some potentially preventable. Hemorrhagic shock is a potentially preventable cause of trauma mortality. A retrospective database review was conducted of the Mississippi Trauma Registry and point-by-serial correlational analyses were conducted to determine the direction of any significant relations between blood product usage, traditional vital signs, and shock index. Pearson correlation, logistic regressions, and odds ratio calculation results revealed that shock index can signal impending hemorrhagic compromise better than traditional vital signs; thus, facilitating early intervention, specifically, as heart rate and shock index increase, the use of blood products increases, and as blood pressure increases, the use of blood products decreases. Independent t tests for shock index and ISS revealed significant differences in the means with relationship to the subgroups "Dead" and "Alive." Higher ISS were found to correlate with higher shock indices. Evaluation of ISS and survivability demonstrates that ISS = 75 is survivable and should not lead one to reflexively assume otherwise. A total mortality finding of only 1.58% (n = 2,010) was unexpected but very encouraging. |
| Databáze: | OpenAIRE |
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