Biochemical Markers as Predictors of In-Hospital Mortality in Patients with Severe Trauma: A Retrospective Cohort Study.
10.4266/kjccm.2017.00360
- Author:
Ha Nee JANG
;
Hyun Oh PARK
;
Tae Won YANG
;
Jun Ho YANG
;
Sung Hwan KIM
;
Seong Ho MOON
;
Joung Hun BYUN
;
Chung Eun LEE
;
Jong Woo KIM
;
Dong Hun KANG
;
Kyeong Hee BAEK
- Publication Type:Original Article
- Keywords:
acidosis;
hemoglobin;
injuries;
international normalized ratio;
mortality
- MeSH:
Acidosis;
Biomarkers*;
Cohort Studies*;
Hospital Mortality*;
Humans;
Hydrogen-Ion Concentration;
Injury Severity Score;
International Normalized Ratio;
Medical Records;
Mortality;
Prothrombin;
Retrospective Studies*;
Sensitivity and Specificity
- From:Korean Journal of Critical Care Medicine
2017;32(3):240-246
- CountryRepublic of Korea
- Language:English
-
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.
