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ORIGINAL ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 3  |  Page : 108-116

Experience at a Critical Care Department with trauma patients: a 5-year registry study


1 Department of Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
2 Department of Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt

Correspondence Address:
Abdou M Alazab
Kasr Elini Old Medical School, Critical Care Departement, Postal code 11562
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/roaic.roaic_86_16

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Background and objective Trauma is the sixth leading cause of death worldwide, resulting in five million or 10% of all deaths annually. Mortality can be grouped into immediate, early, and late deaths. Recognition of these patterns has led to the development of Advanced Trauma Life Support, which is the standard of care for trauma patients, and it is built around a consistent approach to patient evaluation. The aim of our study was to assess and find a way to predict outcomes in trauma patients admitted to the Critical Care Department using admission data (clinical and laboratory) and scoring systems. Patients and methods This was a prospective–retrospective study carried out between January 2010 and December 2014 on 67 trauma patients. Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were obtained. Revised Trauma Score (RTS) was calculated using data collected within the first 24 h of admission. Results Nonsurvivors were relatively younger than survivors (29.16±12.83 vs. 39.69±19.83, P=0.036), and they had more dangerous penetrating injuries compared with survivors. Road traffic accidents were more common among nonsurvivors compared with survivors (penetrating injuries: 16% in survivors vs. 56.2% in nonsurvivors; road traffic accidents: 68% in survivors vs. 37% in nonsurvivors, P=0.025). pH, PaCO2, random blood sugar, and serum sodium were significantly higher in nonsurvivors compared with survivors. Nonsurvivors had a significantly lower Glasgow Coma Score, lower RTS, and higher APACHE II scores than survivors. A receiver operating characteristic curve analysis was carried out, and an APACHE II score of 20 was significant in predicting mortality with an area under the curve of 91.6%, sensitivity of 81.3%, and specificity of 87.2%. In addition, an RTS cutoff score of 6 had an area under the curve of 91.4%, sensitivity of 74.4%, and specificity of 87.5% for predicting mortality. Conclusion Both APACHE II and RTS are better predictors of mortality in trauma patients admitted to ICUs.


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