Early predictors of mortality in polytrauma patients in intensive care units

Abstract

Background: Trauma is a leading cause of morbidity and mortality worldwide. The traumatized patient outcome is multi-factorial  through combination of the clinical diagnosis and presence and severity of comorbidities. Mortality predictors among head trauma  patients are still far from being reported.

Aim: This study aimed to enhance the outcome of the polytrauma patients admitted to  intensive care unit ICU through construct a predictive model for mortality on the basis of easily available parameters.

Methods: Our  cohort prospective study consisted of 60 Egyptian patients from January2020 to January2021 over 16 years old with Glasgow coma scale  (GCS) 4-14 followed traumatic brain injury and full clinical evaluation on admission was done including a full history, clinical examination,  radiological and laboratory investigations. All patients were evaluated according to GCS, APACHE II and RTS scores. In addition, all  patients were followed-up for 2weeks from the day of admission .The primary outcome assessed the mortality with analysis of different  clinical and lab parameters for detection of predictors of mortality.

Results: Sixty patients were with mean age/year was 40.43 ± 16.9 with  58.3% were males. A mortality rate of 45% as non-survivor was detected with a predominance of road traffic accidents as a mode of injury  (51.7%). There is statistically significance of lower scores of GCS and RTS but higher scores of APACHE II in non- survivors than  survivors. Multivariate logistic regression detects that diabetes mellitus (DM) is the most significant predictor of non survivors.  

Conclusion: Multiple significant predictors of mortality were found as: advanced age, low PLT count, high renal function tests and  radiological CT brain findings. DM is the most significant predictor of mortality.