Mortality Risk Factors of Severely Injured Polytrauma Patients (Prehospital Mortality Prediction Score)

The aim of this study was to analyze the mortality of polytrauma patients and identify prediction parameters. A further aim was to create from the results a score for the prehospital predictive evaluation of 30-day survival. The study was conducted with a retrospective, observational design and was carried out unicentrically at a Level 1 Trauma Center. During the 4-year investigation period, patients with an Injury Severity Score (ISS) ≥ 16 were examined and their demographic basic data, laboratory values, and vital parameters were recorded. The mortality data analysis was performed using Kaplan-Meier Analysis and Log-Rank tests. Cox regressions were carried out to determine influencing factors and Receiver Operating Characteristic (ROC) curves were plotted to establish limit values for potential influencing factors. All statistical tests were conducted at a significance level of p ≤ 0.05. Coronary Heart Disease (CHD), cardiopulmonary resuscitation (CPR), age at admission, sex, and Glasgow Coma Scale (GCS) had a significant impact on the survival of polytrauma patients. The identified prediction parameters were combined with the shock index (SI). The generated score showed a sensitivity of 93.1% and a specificity of 73.3% in predicting the mortality risk. The study was able to identify significant influencing prehospital risk factors on 30-day survival after polytrauma. A score created from these parameters showed higher specificity and sensitivity than other prediction scores. Further studies with a larger number of participants and the inclusion of slightly injured patients could verify these findings.