A predictive model of early mortality in trauma patients

David A. Hampton, Tim H. Lee, Brian S. Diggs, Sean P. McCully, Martin A. Schreiber

    Research output: Contribution to journalArticle

    9 Scopus citations

    Abstract

    Background: 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. Methods: 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. Results: 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, hemoglobin <11 g/dL, international normalized ratio >1.5, Ly30 >8%, 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. Conclusions: 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.

    Original languageEnglish (US)
    Pages (from-to)642-647
    Number of pages6
    JournalAmerican journal of surgery
    Volume207
    Issue number5
    DOIs
    StatePublished - May 2014

    Keywords

    • Model
    • Mortality
    • Thrombelastography
    • Trauma

    ASJC Scopus subject areas

    • Surgery

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