Outcome predictors for severely brain-injured patients directly admitted or transferred from emergency departments to a trauma center

doi:10.5847/wjem.j.1920-8642.2020.02.010

World Journal of Emergency Medicine ›› 2020, Vol. 11 ›› Issue (2): 120-121.doi: 10.5847/wjem.j.1920-8642.2020.02.010

Special Issue: Trauma

• Research Letter • Previous Articles Next Articles

Outcome predictors for severely brain-injured patients directly admitted or transferred from emergency departments to a trauma center

Ryne Jenkins¹, Nicholas A. Morris², Bryce Haac¹, Richard Van Besien³, Deborah M. Stein¹, Neeraj Badjatia^1,², Amir Medic⁴, Gaurika Mester⁴, Quincy K. Tran^1,⁵()

¹ Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA
² Section of Neurocritical Care and Emergency Neurology, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
³ University of Maryland School of Medicine, Baltimore, MD, USA
⁴ University of Maryland at College Park, College Park, MD, USA
⁵ Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

Received:2018-12-20 Accepted:2019-07-15 Online:2020-04-01 Published:2020-04-01
Contact: Quincy K. Tran E-mail:qtran@som.umaryland.edu

Abstract

Ryne Jenkins, Nicholas A. Morris, Bryce Haac, Richard Van Besien, Deborah M. Stein, Neeraj Badjatia, Amir Medic, Gaurika Mester, Quincy K. Tran. Outcome predictors for severely brain-injured patients directly admitted or transferred from emergency departments to a trauma center[J]. World Journal of Emergency Medicine, 2020, 11(2): 120-121.

Variables	Univariate analysis			Multivariable analysis
Variables	ORs	95% CI	P-value	ORs	95% CI	P-value
ED clinical factors ^a
ED SI < 0.5 ^*	0.31	0.02-6.1	0.44	11	1.4-87	0.022
Trauma designation - Yes	8.3	1.80-36	0.005	7.6	1.1-51	0.036
Gender	0.235	0.04-1.2	0.09	0.19	0.05-2.6	0.14
Age	0.18	0.53-1.06	0.10	0.78	0.44-1.4	0.41
Triage GCS	1.7	1.04-2.7	0.03	1.3	0.0-3.5	0.46
Worsening GCS at ICU arrival	0.67	0.05-1.01	0.05	0.31	0.0-2.8	0.30
ED mechanical ventilation	2.7	0.80-9.0	0.10	0.01	<0.01-100+	0.65
ED highest FiO₂	3.8	0.78-19	0.10	14	<0.01-100+	0.69
STC clinical factors ^b
HD5GCS ≤ 8	13	5.70-28	0.001	10	5.4-53	<0.001
History of DM	3.6	1.60-8.5	0.003	1.1	0.19-9.3	0.91
Admission GCS	0.90	0.85-0.96	0.001	2.7	0.4-1.1	0.12
Admission SI^**	1.8	0.65-4.9	0.25	2.7	0.3-22	0.36
Admission RR^**	0.99	0.96-1.02	0.73	0.96	0.9-1.04	0.34
Admission PF ratio	0.7	0.58-0.89	0.002	0.70	0.4-1.1	0.12
ISS	1.1	1.02-1.09	0.001	1.0	0.9-1.1	0.89
Receiving EVD	4.8	2.70-8.9	0.001	2.9	0.9-9.3	0.19
Marshall CT score	1.4	1.10-1.8	0.004	0.88	0.5-3.1	0.06
Lung injury score	1.6	1.03-2.3	0.029	1.1	0.5-2.8	0.62

1	Baron DM, Hochrieser H, Metnitz PGH, Mauritz W. Tracheostomy is associated with decreased hospital mortality after moderate or severe isolated traumatic brain injury. Wien Klin Wochenschr. 2016; 128(11-12):397-403. pmid: 27220338
2	Ahmadinegad M, Karamouzian S, Lashkarizadeh MR. Use of glasgow coma scale as an indicator for early tracheostomy in patients with severe head injury. Tanaffos. 2011; 10(1):26-30. pmid: 25191347
3	Cannon CM, Braxton CC, Kling-Smith M, Mahnken JD, Carlton E, Moncure M. Utility of the Shock Index in predicting mortality in traumatically injured patients. J Trauma Inj Infect Crit Care. 2009; 67(6):1426-30. doi: 10.1097/TA.0b013e3181bbf728
4	Perbet S, De Jong A, Delmas J, Futier E, Pereira B, Jaber S, et al. Incidence of and risk factors for severe cardiovascular collapse after endotracheal intubation in the ICU: A multicenter observational study. Crit Care. 2015; 19:257. pmid: 26084896

Outcome predictors for severely brain-injured patients directly admitted or transferred from emergency departments to a trauma center

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 1

References 4

Related Articles 0

Recommended Articles

Comments