Potential risk factors for ın-hospital mortality in patients with moderate-to-severe blunt multipletrauma who survive ınitial resuscitation

dc.contributor.authorYucel, Neslihan
dc.contributor.authorDemir, Tuba Ozturk
dc.contributor.authorDerya, Serdar
dc.contributor.authorOguzturk, Hakan
dc.contributor.authorBicakcioglu, Murat
dc.contributor.authorYetkin, Funda
dc.date.accessioned2019-07-17T11:44:13Z
dc.date.available2019-07-17T11:44:13Z
dc.date.issued2018
dc.departmentİnönü Üniversitesien_US
dc.description.abstractIntroduction. The aim was to identify risk factors that influence in-hospital mortality for patients with moderate-to-severe blunt multiple trauma (BMT) who survive initial resuscitation. Methods. The prospective study involved 195 adult patients with BMT who were admitted to a referral hospital's emergency department (ED) betweenMay 1, 2015, and May 31, 2016. Results. Forty-three (22%) of the 195 patients died in hospital. Multivariate analysis identified low blood pH (odds ratio [OR] 6.580, 95% confidence interval [CI] 1.12-38.51), high serumlactate level (OR 1.041, 95% CI 1.01-1.07), high ISS (OR 1.109, 95% CI 1.06-1.16), high APACHE II score (OR 1.189, 95% CI 1.07-1.33), traumatic brain injury (TBI) (OR 4.358, 95% CI 0.76-24.86), severe hemorrhage (OR 5.314, 95% CI 1.07-26.49), and coagulopathy (OR 5.916, 95% CI 1.17-29.90) as useful predictors of acute in-hospital mortality. High ISS (OR 1.047, 95% CI 1.02-1.08), TBI (OR 8.922, 95% CI 2.57-31.00), sepsis (OR 4.956, 95% CI 1.99-12.36), acute respiratory distress syndrome (ARDS) (OR 8.036, 95% CI 1.85-34.84), respiratory failure (OR 9.630, 95% CI 2.64-35.14), renal failure (OR 74.803, 95% CI 11.34-493.43), and multiple organ failure [MOF] (OR 10.415, 95% CI 4.48-24.24) were risk factors for late in-hospital mortality. High Glasgow Coma Scale (GCS) was a good predictor for survival at 2, 7, and 28 or more days of hospitalization (OR 0.708 and 95% CI 0.56-0.09; OR 0.835 and 95% CI 0.73-0.95; OR 0.798 and 95% CI 0.71-0.90, resp.). Conclusion. Several factors signal poor short-term outcome for patients who present to the ED with moderate-to-severe BMT: low blood pH, high serum lactate level, presence of TBI, severe hemorrhage, coagulopathy, organ failure (respiratory, renal, and MOF), and ARDS. For this patient group, ISS and APACHE II scores might be helpful for stratifying by mortality risk, and GCS might be a good predictor for survival.en_US
dc.identifier.citationYucel, N. Demir, TO. Derya, S. Oguzturk, H. Bicakcioglu, M. Yetkin, F . (2018). Potential risk factors for ın-hospital mortality in patients with moderate-to-severe blunt multipletrauma who survive ınitial resuscitation.en_US
dc.identifier.doi10.1155/2018/6461072en_US
dc.identifier.endpage0en_US
dc.identifier.issue0en_US
dc.identifier.startpage0en_US
dc.identifier.urihttps://hdl.handle.net/11616/12686
dc.identifier.volume0en_US
dc.language.isoenen_US
dc.publisherHındawı ltd, adam house, 3rd flr, 1 fıtzroy sq, london, w1t 5hf, englanden_US
dc.relation.ispartofEmergency medıcıne ınternatıonalen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectRespıratory-dıstress-syndromeen_US
dc.subjectorgan faılureen_US
dc.subjectbase defıcıt; early coagulopathyen_US
dc.subjectend-poıntsen_US
dc.subjectınjuryen_US
dc.subjectscoreen_US
dc.subjectepıdemıologyen_US
dc.subjectpredıctorsen_US
dc.subjectlactateen_US
dc.titlePotential risk factors for ın-hospital mortality in patients with moderate-to-severe blunt multipletrauma who survive ınitial resuscitationen_US
dc.typeArticleen_US

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