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A Novel Approach to Identify Polytraumatized Patients in Extremis
Lukas L Negrin1, Anna Antoni1, Stefan Hajdu1
1Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria.
Biomed Research International
|June 1, 2018
Summary
Identifying polytraumatized patients in extremis early is vital. A new definition identified these critical patients, revealing age and Injury Severity Score (ISS) as key mortality predictors.
Area of Science:
- Trauma Surgery
- Critical Care Medicine
- Emergency Medicine
Background:
- Early identification of polytraumatized patients in extremis is critical for timely life-saving interventions.
- Defining this high-risk group aids in resource allocation and treatment prioritization.
Purpose of the Study:
- To develop and validate a definition for polytraumatized patients in extremis.
- To identify predictors of mortality within this critically ill patient cohort.
Main Methods:
- A definition for "in extremis" was established based on seven physiological parameters (e.g., low hemoglobin, high lactate).
- Polytraumatized patients (ISS ≥ 16) meeting ≥5 criteria were retrospectively identified.
- Comparison was made with an age-, gender-, and ISS-matched "non-in extremis" group.
Main Results:
- The "in extremis" group (n=64) had a significantly higher mortality rate (56.3%) compared to the control group (18.9%).
- Age and Injury Severity Score (ISS) were identified as independent predictors of mortality within the "in extremis" cohort.
Conclusions:
- The proposed definition effectively identifies polytraumatized patients with a high mortality risk.
- This definition may function as an early warning score to guide clinical decision-making in trauma care.
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