Author/Authors :
Jang, Ha Nee Department of Internal Medicine - Gyeongsang National University Hospital - Gyeongsang National University School of Medicine and Institute of Health Sciences, Jinju , Park, Hyun Oh Department of Thoracic and Cardiovascular Surgery - Gyeongsang National University Changwon Hospital - Gyeongsang National University School of Medicine and Institute of Health Sciences, Changwon , Yang, Tae Won Department of Neurology - Gyeongsang National University Changwon Hospital, Changwon , Yang, Jun Ho Department of Thoracic and Cardiovascular Surgery - Gyeongsang National University Hospital - Gyeongsang National University School of Medicine and Institute of Health Sciences, Jinju , Kim, Sung Hwan Department of Thoracic and Cardiovascular Surgery - Gyeongsang National University Changwon Hospital - Gyeongsang National University School of Medicine and Institute of Health Sciences, Changwon , Moon, Seong Ho Department of Thoracic and Cardiovascular Surgery - Gyeongsang National University Changwon Hospital - Gyeongsang National University School of Medicine and Institute of Health Sciences, Changwon , Byun, Joung Hun Department of Thoracic and Cardiovascular Surgery - Gyeongsang National University Changwon Hospital - Gyeongsang National University School of Medicine and Institute of Health Sciences, Changwon , Lee, Chung Eun Department of Thoracic and Cardiovascular Surgery - Gyeongsang National University Hospital - Gyeongsang National University School of Medicine and Institute of Health Sciences, Jinju , Kim, Jong Woo Department of Thoracic and Cardiovascular Surgery - Gyeongsang National University Changwon Hospital - Gyeongsang National University School of Medicine and Institute of Health Sciences, Changwon , Kang, Dong Hun Department of Thoracic and Cardiovascular Surgery - Gyeongsang National University Hospital - Gyeongsang National University School of Medicine and Institute of Health Sciences, Jinju , Baek, Kyeong Hee Department of Neurosurgery - Gyeongsang National University Changwon Hospital - Changwon, Korea
Abstract :
Background: Initial evaluation of injury severity in trauma patients is an important and challenging task. We aimed to assess whether
easily measurable biochemical parameters (hemoglobin, pH, and prothrombin time/international normalized ratio [PT/INR]) can predict in-hospital mortality in patients with severe trauma.
Methods: This retrospective study involved review of the medical records of 315 patients with severe trauma and an injury severity
score >15 who were managed at Gyeongsang National University Hospital between January 2005 and December 2015. We extracted
the following data: in-hospital mortality, injury severity score, and initial hemoglobin level, pH, and PT/INR. The predictive values of
these variables were compared using receiver operation characteristic curves.
Results: Of the 315 patients, 72 (22.9%) died. The in-hospital mortality rates of patients with hemoglobin levels <8.4 g/dl and ≥8.4
g/dl were 49.8% and 9.9%, respectively (P < 0.001). At a cutoff hemoglobin level of 8.4 g/dl, the sensitivity and specificity values for
mortality were 81.9% and 86.4%, respectively. At a pH cutoff of 7.25, the sensitivity and specificity values for mortality were 66.7% and
77.8%, respectively; 66.7% of patients with a pH <7.25 died versus 22.2% with a pH ≥7.25 (P < 0.001). The in-hospital mortality rates
for patients with PT/INR values ≥1.4 and <1.4 were 37.5% and 16%, respectively (P < 0.001; sensitivity, 37.5%; specificity, 84%).
Conclusions: Using the suggested cutoff values, hemoglobin level, pH, and PT/INR can simply and easily be used to predict in-hospital mortality in patients with severe trauma.
Keywords :
acidosis , hemoglobin , injuries , international normalized ratio , mortality
