Abstract text (incl. references and figure legends)
Introduction: The majority of trauma-related mortality occurs early following injury, and it is the leading cause of deaths and disability worldwide. However, the patient outcomes can be improved by identifying the risk factors for early mortality in trauma settings. Herein, we aim to identify factors predicting early mortality in trauma patients.
Methods: A retrospective study was conducted to review all trauma-related mortality cases registered between 2013 and 2018 at HGH. Patients were divided and analyzed based on the time of mortality i.e. early (≤48 hours) and late (>48 hours) deaths. Multivariate regression analysis was performed to identify the factors associated with early mortality.
Results: During the study period, there were 8,624 trauma admissions; of them 354 (4.1%) patients died who were predominantly males, with a mean age of 35.8±17.2 years. The mortality pattern peaked immediately after injury (n = 323), followed by 70 mortalities within the first day, 43 mortalities in second day, 124 mortalities within the 3-7 day (second peak), and 127 mortalities after one week. Those who died early were more likely to have lower GCS, higher shock index, chest, and abdominal AIS and frequently required exploratory laparotomy and massive blood transfusion (p<0.005). Whereas, higher injury severity score and frequent head injuries were observed in the late group. On multivariate analysis, shock index (OR 2.26; 95% CI 1.04-4.925; p=0.04) was an independent predictor for early deaths, whereas head injury was a predictor for late deaths (OR 0.22; 95% CI 0.09-0.52; p=0.001).
Conclusion: One third of trauma-related mortalities occurred early following injury. Initial shock index seems to be a reliable hemodynamic indicator to predict early mortality in trauma patients. Therefore, timely hemostatic resuscitation and appropriate interventions for bleeding control may prevent early mortality post-trauma.
Reference: Jin WY et al (2018) doi: 10.5505/tjtes.2018.29434
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