Index Analysis on Early Prediction of Survival Time in Severe Multiple Trauma Patients_West China Medical Journal

Authors：

 LüLin , HuHai ,  CaoYu

Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

CaoYu, Email: yuyuer@126.com

Keywords：

Severe multiple trauma; Point of care test; Survival time; Early prediction

DOI：

10.7507/1002-0179.201600452

Video：

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Objective To study the value of revised trauma scores (RTS), major trauma outcome study (MTOS)-RTS scores and point of care test (POCT) in the early forecast of survival time in severe multiple trauma patients. Methods Multiple trauma patients treated in the Emergency Department of our hospital between September and December 2015 were included in our study. We collected such data as the basic information on admission, physical signs (breath, blood pressure, state of consciousness) and POCT indexes, including pH value, hemoglobin, base excess, hematocrit value, lactic acid, sodium, anion gap, and blood glucose. We calculated each patient's RTS and MTOS-RTS scores. According to the 30-day prognosis, the patients were divided into survival group and death group. Risk factors for survival time were screened by Cox regression risk model. Results Seventy-five multiple trauma patients were included in our study. Among them, there were 51 males and 24 females. Fourteen of them died. The multivariate analysis in the Cox regression risk model showed that the risk factors for the death of multiple trauma patients included MOTS-RTS score [RR=0.726, 95%CI (0.608, 0.867), P < 0.001) and POCT lactic acid level [RR=1.139, 95%CI (1.010, 1.324), P=0.037]. Conclusion MOTS-RTS combined with lactic acid level may be used in the early forecast of survival time in severe multiple trauma patients.

Citation： LüLin, HuHai, CaoYu. Index Analysis on Early Prediction of Survival Time in Severe Multiple Trauma Patients. West China Medical Journal, 2016, 31(10): 1641-1644. doi: 10.7507/1002-0179.201600452 Copy

1.	胡海, 杜鑫淼, 曹钰.以休克指数作参数的修正创伤评分在地震现场躯干伤伤员转运前伤情评估时的应用价值[J].中国急救复苏与灾害医学杂志, 2015, 10(5): 415-419.
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5.	裴辉, 罗志毅, 刘保池.四种院前创伤评分对急诊创伤患者的评估研究[J].中华临床医师杂志:电子版, 2011, 5(15): 4394-4400.
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10.	曹相原, 王晓红, 马少林.应激性高血糖症与胰岛素抵抗的相关因素研究[J].中国危重病急救医学, 2006, 18(12): 751-754.
11.	林毅.损伤严重度评分在80例急性多发创伤患者临床中的应用价值研究[J].黑龙江医学, 2015, 39(1): 50-51.
12.	林一丹, 杨晓妍, 石应康.修正创伤评分在急诊躯干损伤救治中的应用与改良[J].中国胸心血管外科临床杂志, 2013, 20(2): 181-184.
13.	张红红, 温静兰, 陈军方.修正创伤评分在多发伤患者急救中的应用[J].现代临床护理, 2015, 14(6): 37-40.
14.	Moore L, Lavoie A, Lesage N, et al. Statistical validation of the Revised Trauma Score[J]. J Trauma, 2006, 60(2): 305-311.
15.	陈罡, 叶文玲, 秦岩, 等.代偿性酸中毒、炎性反应和病因是影响急性肾损伤预后的重要因素[J].基础医学与临床, 2015, 35(5): 648-653.
16.	于欣, 王潇然, 刘月英, 等.血pH值和乳酸水平判断心肺复苏患者预后的临床价值[J].中国老年学杂志, 2013, 33(24): 6123-6124.
17.	何朝晖, 支兴刚.创伤性脑损伤后高血糖的发生机制及对预后的影响[J].创伤外科杂志, 2004, 6(2): 149-151.
18.	Monnier L, Colette C. Glycemic variability: should we and can we prevent it? [J]. Diabetes Care, 2008, 31(Suppl 2): S150-S154.
19.	Montmany Vioque S, Navarro Soto S, Rebasa Cladera P, et al. Measurement of lacticacid in multiple injury patients and its usefulness as a predictor of multiorgan failure andmortality[J]. Cir Esp, 2012, 90(2): 107-113.
20.	Guyette F, Suffoletto B, Castillo JL, et al. Prehospital serum lactate as a predictor of outcomes in trauma patients: a retrospective observational study[J]. Trauma, 2011, 70(4): 782-786.

1. 胡海, 杜鑫淼, 曹钰.以休克指数作参数的修正创伤评分在地震现场躯干伤伤员转运前伤情评估时的应用价值[J].中国急救复苏与灾害医学杂志, 2015, 10(5): 415-419.
2. 张连阳.重视多发伤的精确伤情评估[J].重庆医学, 2010, 39(9): 1025-1026.
3. 曲纪富, 文亮, 刘明华, 等.严重多发伤伴创伤性休克的诊治分析[J].中国急救医学, 2009, 29(5): 401-404.
4. Sloan EP, Koenigsberg M, Clark JM, et al. The use of the Revised Trauma Score as an entry criterion in traumatic hemorrhagic shock studies: data from the DCLHb clinical trials[J]. Prehosp Disaster Med, 2012, 27(4): 330-344.
5. 裴辉, 罗志毅, 刘保池.四种院前创伤评分对急诊创伤患者的评估研究[J].中华临床医师杂志:电子版, 2011, 5(15): 4394-4400.
6. 裴辉, 刘保池.我国院前创伤评分系统的应用现状及展望[J].世界急危重病医学杂志, 2007, 4(5): 2079-2085.
7. 梁连生, 张建平. APACHEⅡ评分与血乳酸水平对ICU多发伤患者预后的评估应用[J].内蒙古医学杂志, 2013, 45(10): 1189-1191.
8. 王昊, 吴大玮, 陈晓梅, 等.血乳酸水平及清除率和升高时间与重症监护病房危重患者预后的关系[J].中国危重病急救医学, 2009, 21(6): 357-360.
9. 刘朝晖, 吴金春, 廖银光, 等.多发伤患者血糖水平及血糖变异性与预后的相关性分析[J].中国危重病急救医学, 2012, 24(11): 643-646.
10. 曹相原, 王晓红, 马少林.应激性高血糖症与胰岛素抵抗的相关因素研究[J].中国危重病急救医学, 2006, 18(12): 751-754.
11. 林毅.损伤严重度评分在80例急性多发创伤患者临床中的应用价值研究[J].黑龙江医学, 2015, 39(1): 50-51.
12. 林一丹, 杨晓妍, 石应康.修正创伤评分在急诊躯干损伤救治中的应用与改良[J].中国胸心血管外科临床杂志, 2013, 20(2): 181-184.
13. 张红红, 温静兰, 陈军方.修正创伤评分在多发伤患者急救中的应用[J].现代临床护理, 2015, 14(6): 37-40.
14. Moore L, Lavoie A, Lesage N, et al. Statistical validation of the Revised Trauma Score[J]. J Trauma, 2006, 60(2): 305-311.
15. 陈罡, 叶文玲, 秦岩, 等.代偿性酸中毒、炎性反应和病因是影响急性肾损伤预后的重要因素[J].基础医学与临床, 2015, 35(5): 648-653.
16. 于欣, 王潇然, 刘月英, 等.血pH值和乳酸水平判断心肺复苏患者预后的临床价值[J].中国老年学杂志, 2013, 33(24): 6123-6124.
17. 何朝晖, 支兴刚.创伤性脑损伤后高血糖的发生机制及对预后的影响[J].创伤外科杂志, 2004, 6(2): 149-151.
18. Monnier L, Colette C. Glycemic variability: should we and can we prevent it? [J]. Diabetes Care, 2008, 31(Suppl 2): S150-S154.
19. Montmany Vioque S, Navarro Soto S, Rebasa Cladera P, et al. Measurement of lacticacid in multiple injury patients and its usefulness as a predictor of multiorgan failure andmortality[J]. Cir Esp, 2012, 90(2): 107-113.
20. Guyette F, Suffoletto B, Castillo JL, et al. Prehospital serum lactate as a predictor of outcomes in trauma patients: a retrospective observational study[J]. Trauma, 2011, 70(4): 782-786.

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