Sameh Saad1, Naglaa Mohamed2, Amr Moghazy3, Gouda Ellabban3, Soliman El-Kamash3. 1. Department of Emergency Medicine, Suez Canal University Faculty of Medicine, Ismailia, Egypt. sameh_er2005@hotmail.com. 2. Department of Emergency Medicine, Suez Canal University Faculty of Medicine, Ismailia, Egypt. 3. Department of General Surgery, Suez Canal University Faculty of Medicine, Ismailia, Egypt.
Abstract
BACKGROUND: The trauma and injury severity score (TRISS) and Acute Physiology and Chronic Health Evaluation IV (APACHE IV) are accurate but complex. This study aimed to compare venous glucose, levels of serum lactate, and base deficit in polytraumatized patients as simple parameters to predict the mortality in these patients versus (TRISS) and (APACHE IV). METHODS: This was a comparative cross-sectional study of 282 patients with polytrauma presented to the Emergency Department (ED). RESULTS: The best cut off value of TRISS probability of survival score for prediction of mortality among poly-traumatized patients was ≤90. APACHE IV demonstrated 67% sensitivity and 95% specificity at 95% CI at cut off point 99. The best cutoff value of Random Blood Sugar was >140 mg/dl, with 89% sensitivity, 49% specificity; base deficit was less than -5.6 with 64% sensitivity, 93% specificity; lactate was >2.6 mmol/L with 92%, sensitivity, 42% specificity. CONCLUSION: Venous glucose, serum lactate and base deficit are easy and rapid biochemical predictors of mortality in patients with polytrauma. These predictors could be used as TRISS and APACHE IV in predicting mortality.
BACKGROUND: The trauma and injury severity score (TRISS) and Acute Physiology and Chronic Health Evaluation IV (APACHE IV) are accurate but complex. This study aimed to compare venous glucose, levels of serum lactate, and base deficit in polytraumatized patients as simple parameters to predict the mortality in these patients versus (TRISS) and (APACHE IV). METHODS: This was a comparative cross-sectional study of 282 patients with polytrauma presented to the Emergency Department (ED). RESULTS: The best cut off value of TRISS probability of survival score for prediction of mortality among poly-traumatized patients was ≤90. APACHE IV demonstrated 67% sensitivity and 95% specificity at 95% CI at cut off point 99. The best cutoff value of Random Blood Sugar was >140 mg/dl, with 89% sensitivity, 49% specificity; base deficit was less than -5.6 with 64% sensitivity, 93% specificity; lactate was >2.6 mmol/L with 92%, sensitivity, 42% specificity. CONCLUSION:Venous glucose, serum lactate and base deficit are easy and rapid biochemical predictors of mortality in patients with polytrauma. These predictors could be used as TRISS and APACHE IV in predicting mortality.
Authors: Rameshbabu Homanna Javali; Prithvishree Ravindra; Akkamahadevi Patil; Madhu Srinivasarangan; Harshit Mundada; S B Adarsh; S Nisarg Journal: Indian J Crit Care Med Date: 2017-11