Predictors of Mortality for Multiple Trauma Patients with Severe Thoracic Trauma During Intensive Care of The Early Posttraumatic Period

Background: Continuous status severity evaluation of the polytraumatized patient during early posttraumatic period is crucial for triage, quality management, assessment of mortality prediction and the scientific study of trauma. The aim of this study was to investigate simple criteria of outcome prediction for multiple trauma patients with severe thoracic trauma during intensive care of the early posttraumatic period.Methods: This single-center prospective observational cohort study involved 73 adult male polytraumatized patients with blunt mechanism and Abbreviated Injury Scale (AIS) thorax =3. The receiver operating characteristic analyses were performed for identification of predictive cut-off values among blood laboratory assays performed on the 1(st)-2(nd), 3(rd)-4(th) and 5(th)-6(th) days after trauma and the polytrauma scales. Results: The highest odds ratios for outcome prediction were estimated for the Trauma and Injury Severity Score (TRISS), Revised Trauma Score (RTS) and AIS head. On the 1(st)-2(nd) day risk factors for adverse outcome were identified among total protein (TP) concentration, creatinine and oxygen content. On the 3(rd)-4(th) day - TP, band neutrophils and white blood cells count. On the 5(th)-6(th) day - TP, monocytes and red blood cells count.Conclusions: Investigated simple criteria can be used for monitoring the clinical course of polytraumatized patients and for recognizing those at high risk of negative outcomes. The same predictive markers can't be used during the whole early posttraumatic period for multiple trauma patients with severe thoracic trauma as specific predictive signs belong to each of the investigated time periods. Predictive powers of estimated markers are different depending on time period.