Independent early predictors of mortality in polytrauma patients: a prospective, observational, longitudinal study

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorCOSTA, Luiz Guilherme V. da
dc.contributor.authorCARMONA, Maria Jose C.
dc.contributor.authorMALBOUISSON, Luiz M.
dc.contributor.authorRIZOLI, Sandro
dc.contributor.authorROCHA-FILHO, Joel Avancini
dc.contributor.authorCARDOSO, Ricardo Galesso
dc.contributor.authorAULER-JUNIOR, Jose Otavio C.
dc.date.accessioned2017-12-12T13:13:49Z
dc.date.available2017-12-12T13:13:49Z
dc.date.issued2017
dc.description.abstractOBJECTIVES: Trauma is an important public health issue and associated with substantial socioeconomic impacts and major adverse clinical outcomes. No single study has previously investigated the predictors of mortality across all stages of care (pre-hospital, emergency room, surgical center and intensive care unit) in a general trauma population. This study was designed to identify early predictors of mortality in severely injured polytrauma patients across all stages of care to provide a better understanding of the physiologic changes and mechanisms by which to improve care in this population. METHODS: A longitudinal, prospective, observational study was conducted between 2010 and 2013 in Sao Paulo, Brazil. Patients submitted to high-energy trauma were included. Exclusion criteria were as follows: injury severity score <16, <18 years old or insufficient data. Clinical and laboratory data were collected at four time points: pre-hospital, emergency room, and 3 and 24 hours after hospital admission. The primary outcome assessed was mortality within 30 days. Data were analyzed using tests of association as appropriate, nonparametric analysis of variance and generalized estimating equation analysis (p<0.05). ClinicalTrials.gov: NCT01669577. RESULTS: Two hundred patients were included. Independent early predictors of mortality were as follows: arterial hemoglobin oxygen saturation (p<0.001), diastolic blood pressure (p<0.001), lactate level (p<0.001), Glasgow Coma Scale score (p<0.001), infused crystalloid volume (p<0.015) and presence of traumatic brain injury (p<0.001). CONCLUSION: Our results suggest that arterial hemoglobin oxygen saturation, diastolic blood pressure, lactate level, Glasgow Coma Scale, infused crystalloid volume and presence of traumatic brain injury are independent early mortality predictors.
dc.description.indexMEDLINE
dc.description.sponsorshipSao Paulo State Research Foundation (Fundacao de Amparo Pesquisa do Estado de Sao Paulo - FAPESP)
dc.description.sponsorshipSao Paulo State Research Foundation (Fundacao de Amparoa Pesquisa do Estado de Sao Paulo - FAPESP) [2010/03315-4]
dc.identifier.citationCLINICS, v.72, n.8, p.461-468, 2017
dc.identifier.doi10.6061/clinics/2017(08)02
dc.identifier.eissn1980-5322
dc.identifier.issn1807-5932
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/24165
dc.language.isoeng
dc.publisherHOSPITAL CLINICAS, UNIV SAO PAULO
dc.relation.ispartofClinics
dc.rightsopenAccess
dc.rights.holderCopyright HOSPITAL CLINICAS, UNIV SAO PAULO
dc.subjectMultiple Trauma
dc.subjectIndicators
dc.subjectMortality
dc.subjectShock
dc.subjectBrain Injuries
dc.subjectAnoxia
dc.subject.othersecondary brain-injury
dc.subject.othertrauma patients
dc.subject.otherprospective multicenter
dc.subject.otherdeveloping-countries
dc.subject.otherfluid resuscitation
dc.subject.otherhospital mortality
dc.subject.otherhead-injury
dc.subject.otherdata-bank
dc.subject.otherlactate
dc.subject.otherhypotension
dc.subject.wosMedicine, General & Internal
dc.titleIndependent early predictors of mortality in polytrauma patients: a prospective, observational, longitudinal study
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryCanadá
hcfmusp.affiliation.countryisoca
hcfmusp.author.externalRIZOLI, Sandro:Univ Toronto, Trauma & Acute Care Serv, St Michaels Hosp, Toronto, ON, Canada
hcfmusp.author.externalCARDOSO, Ricardo Galesso:Secretaria Estado Saude Sao Paulo, GRAU, Sao Paulo, SP, Brazil
hcfmusp.citation.scopus26
hcfmusp.contributor.author-fmusphcLUIZ GUILHERME VILLARES DA COSTA
hcfmusp.contributor.author-fmusphcMARIA JOSE CARVALHO CARMONA
hcfmusp.contributor.author-fmusphcLUIZ MARCELO SA MALBOUISSON
hcfmusp.contributor.author-fmusphcJOEL AVANCINI ROCHA FILHO
hcfmusp.contributor.author-fmusphcJOSE OTAVIO COSTA AULER JUNIOR
hcfmusp.description.beginpage461
hcfmusp.description.endpage468
hcfmusp.description.issue8
hcfmusp.description.volume72
hcfmusp.origemWOS
hcfmusp.origem.pubmed28954004
hcfmusp.origem.scieloSCIELO:S1807-59322017000800461
hcfmusp.origem.scopus2-s2.0-85030162035
hcfmusp.origem.wosWOS:000411803900002
hcfmusp.publisher.citySAO PAULO
hcfmusp.publisher.countryBRAZIL
hcfmusp.relation.referenceAndersen LW, 2013, MAYO CLIN PROC, V88, P1127, DOI 10.1016/j.mayocp.2013.06.012
hcfmusp.relation.referenceAndriessen TMJC, 2011, J NEUROTRAUM, V28, P2019, DOI 10.1089/neu.2011.2034
hcfmusp.relation.referenceArroyo W, 2013, INJURY, V44, P1745, DOI 10.1016/j.injury.2013.08.007
hcfmusp.relation.referenceBarfod C, 2012, SCAND J TRAUMA RESUS, V20, DOI 10.1186/1757-7241-20-28
hcfmusp.relation.referenceBarmparas G, 2014, J CRIT CARE, V29, P936, DOI 10.1016/j.jcrc.2014.06.023
hcfmusp.relation.referenceBattle CE, 2014, CRIT CARE, V18, DOI 10.1186/cc13873
hcfmusp.relation.referenceBelzunegui T, 2013, AM J EMERG MED, V31, P1382, DOI 10.1016/j.ajem.2013.06.026
hcfmusp.relation.referenceBICKELL WH, 1994, NEW ENGL J MED, V331, P1105, DOI 10.1056/NEJM199410273311701
hcfmusp.relation.referenceBorthwick HA, 2012, ANN CLIN BIOCHEM, V49, P391, DOI 10.1258/acb.2011.011227
hcfmusp.relation.referenceBOYD CR, 1987, J TRAUMA, V27, P370
hcfmusp.relation.referenceBoyd JH, 2011, CRIT CARE MED, V39, P259, DOI 10.1097/CCM.0b013e3181feeb15
hcfmusp.relation.referenceBrenner M, 2012, J TRAUMA ACUTE CARE, V72, P1135, DOI 10.1097/TA.0b013e31824af90b
hcfmusp.relation.referenceBrown JB, 2013, J TRAUMA ACUTE CARE, V74, P1207, DOI 10.1097/TA.0b013e31828c44fd
hcfmusp.relation.referenceCherkas David, 2011, Emerg Med Pract, V13, P1
hcfmusp.relation.referenceCHESNUT RM, 1993, J TRAUMA, V34, P216, DOI 10.1097/00005373-199302000-00006
hcfmusp.relation.referenceCHESNUT RM, 1993, ACTA NEUROCHIR, P121
hcfmusp.relation.referenceChi JH, 2006, J TRAUMA, V61, P1134, DOI 10.1097/01.ta.0000196644.64653.d8
hcfmusp.relation.referenceClark DE, 2007, J TRAUMA, V62, P592, DOI 10.1097/01.ta.0000257239.154236.29
hcfmusp.relation.referenceCudworth M, 2013, WORLD J EMERG SURG, V8, DOI 10.1186/1749-7922-8-59
hcfmusp.relation.referenceDavenport R, 2013, TRANSFUSION, V53, p23S, DOI 10.1111/trf.12032
hcfmusp.relation.referenceDziura James D., 2013, Yale Journal of Biology and Medicine, V86, P343
hcfmusp.relation.referenceGosselin RA, 2009, B WORLD HEALTH ORGAN, V87, P246, DOI 10.2471/BLT.08.052290
hcfmusp.relation.referenceGourgiotis S, 2013, CRIT CARE NURSE, V33, P18, DOI 10.4037/ccn2013395
hcfmusp.relation.referenceHaider AH, 2012, J AM COLL SURGEONS, V214, P756, DOI 10.1016/j.jamcollsurg.2011.12.013
hcfmusp.relation.referenceHampton DA, 2014, AM J SURG, V207, P642, DOI 10.1016/j.amjsurg.2013.12.009
hcfmusp.relation.referenceHampton DA, 2013, J TRAUMA ACUTE CARE, V75, pS9, DOI 10.1097/TA.0b013e318290cd52
hcfmusp.relation.referenceHefny AF, 2013, AFR HEALTH SCI, V13, P731, DOI 10.4314/ahs.v13i3.30
hcfmusp.relation.referenceHellewell SC, 2010, J NEUROTRAUM, V27, P1997, DOI 10.1089/neu.2009.1245
hcfmusp.relation.referenceHolstein JH, 2012, CLIN ORTHOP RELAT R, V470, P2090, DOI 10.1007/s11999-012-2276-9
hcfmusp.relation.referenceHung KKC, 2009, EMERG MED J, V26, P118, DOI 10.1136/emj.2008.070797
hcfmusp.relation.referenceKarpati PCJ, 2004, ANESTHESIOLOGY, V100, P30, DOI 10.1097/00000542-200401000-00009
hcfmusp.relation.referenceKondo Y, 2011, CRIT CARE, V15, DOI 10.1186/cc10348
hcfmusp.relation.referenceKruse O, 2011, SCAND J TRAUMA RESUS, V19, DOI 10.1186/1757-7241-19-74
hcfmusp.relation.referenceLey EJ, 2012, J TRAUMA ACUTE CARE, V72, P943, DOI 10.1097/TA.0b013e3182465527
hcfmusp.relation.referenceLingsma HF, 2011, NEUROSURGERY, V68, P601, DOI 10.1227/NEU.0b013e318209333b
hcfmusp.relation.referenceMajdan M, 2014, SCAND J TRAUMA RESUS, V22, DOI 10.1186/s13049-014-0068-9
hcfmusp.relation.referenceMyburgh JA, 2015, J INTERN MED, V277, P58, DOI 10.1111/joim.12326
hcfmusp.relation.referenceO'Reilly GM, 2013, INJURY, V44, P713, DOI 10.1016/j.injury.2013.02.003
hcfmusp.relation.referenceOdom SR, 2013, J TRAUMA ACUTE CARE, V74, P999, DOI 10.1097/TA.0b013e3182858a3e
hcfmusp.relation.referencePeden M, 2002, INJURY CHART BOOK GR
hcfmusp.relation.referencePerel P, 2012, BRIT MED J, V345, DOI 10.1136/bmj.e5166
hcfmusp.relation.referenceRahbar E, 2013, J TRAUMA ACUTE CARE, V75, pS16, DOI 10.1097/TA.0b013e31828fa535
hcfmusp.relation.referenceReichenheim ME, 2011, LANCET, V377, P1962, DOI 10.1016/S0140-6736(11)60053-6
hcfmusp.relation.referenceSAUAIA A, 1995, J TRAUMA, V38, P185, DOI 10.1097/00005373-199502000-00006
hcfmusp.relation.referenceShakur H, 2010, LANCET, V376, P23, DOI 10.1016/S0140-6736(10)60835-5
hcfmusp.relation.referenceStocchetti N, 1996, J TRAUMA, V40, P764, DOI 10.1097/00005373-199605000-00014
hcfmusp.relation.referenceThomas ME, 2015, KIDNEY INT, V87, P62, DOI 10.1038/ki.2014.328
hcfmusp.relation.referenceTobias AZ, 2014, PREHOSP EMERG CARE, V18, P321, DOI 10.3109/10903127.2013.869645
hcfmusp.relation.referenceZEGER SL, 1986, BIOMETRICS, V42, P121, DOI 10.2307/2531248
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