Outcome prediction criteria for multiple trauma patients with combined cranio-thoracic injuries

Authors

  • Myroslav Stupnytskyi Department of Anesthesiology and Intensive Care in the Neurosurgery and Neurology Clinic, Military Medical Clinical Center of the Western Region, Lviv, Ukraine https://orcid.org/0000-0003-2960-1806
  • Oleksii Biletskyi Department of Anesthesiology and Intensive Care for Patients with Combined Trauma, Kharkiv Clinical Emergency Hospital named by prof. O.I. Meshchaninov, Kharkiv, Ukraine; Department of Medicine of Catastrophes and Military Medicine, Kharkiv National Medical University, Kharkiv, Ukraine https://orcid.org/0000-0001-8638-4823

DOI:

https://doi.org/10.15584/ejcem.2025.1.17

Keywords:

blunt injury, clinical decision rules, critical care, hospital mortality, multiple trauma

Abstract

Introduction and aim. Blunt chest trauma and traumatic brain injury are considered two of the most significant injury entities with a high potential for complications. In the early post-traumatic period, trauma care frequently encounters limitations in diagnostic capabilities within trauma centers. The objective of this study was to develop simple signs to predict outcomes at three time points during the early post-traumatic period for patients with multiple blunt trauma with combined cranio-tho racic injuries.

Material and methods. This retrospective cohort study was conducted on 51 polytraumatized male patients. Examinations of the patients were performed on the 1st–2nd, 3rd–4th,and 5th–6th day after trauma. Mortality was set as the primary outcome. Re ceiver operating characteristic curve analysis was used to investigate the predictive capacity of the estimated markers for each time period.

Results. The most significant differences between survivors and non-survivors on the 1st to 2nd day after trauma were ob served in terms of SpO2 /FiO2 index, hemoglobin and red blood cell count. On the 3rd–4th day – SpO2 /FiO2 index. The oxygen content, SpO2 /FiO2 index and hemoglobin exhibited the greatest disparity between patients groups on the 5th–6th day.

Conclusion. A set of criteria can be employed to monitor the clinical course of multiple trauma patients with combined cra nio-thoracic injuries. The predictive value of special markers varies depending on the time period. Each of the investigated time periods is characterized by its own specific predictive signs. The predictive capacity of the estimated markers varies depending on the time period under consideration. It is not an accurate approach to employ the same predictive markers throughout the entire posttraumatic period.

Downloads

Download data is not yet available.

References

Crawford AM, Yang S, Hu P, et al. Concomitant chest trauma and traumatic brain injury, biomarkers correlate with worse outcomes. J Trauma Acute Care Surg. 2019;87(1):146-151. doi: 10.1097/TA.0000000000002256

Pape HC, Peitzman AB, Schwab CW, Giannoudis PV. Damage Control Management in the Polytrauma Patient. Springer, 2010.

Bharadwaj S, Naik S. Critical Care Management of Traumatic Brain Injury. Journal of Neuroanaesthesiology and Critical Care. 2019;06(03):187-199. doi: 10.1055/s-0039-1692026

Schieren M, Wappler F, Wafaisade A, et al. Impact of blunt chest trauma on outcome after traumatic brain injurya matched-pair analysis of the TraumaRegister DGU®. Scand J Trauma Resusc Emerg Med. 2020;28(1):21. doi: 10.1186/s13049-020-0708-1

Lundin A, Akram SK, Berg L, Göransson KE, Enocson A. Thoracic injuries in trauma patients: epidemiology and its influence on mortality. Scand J Trauma Resusc Emerg Med. 2022;30(1):69. doi: 10.1186/s13049-022-01058-6

Watanabe T, Kawai Y, Iwamura A, Maegawa N, Fukushima H, Okuchi K. Outcomes after Traumatic Brain Injury with Concomitant Severe Extracranial Injuries. Neurol Med Chir(Tokyo). 2018;58(9):393-399. doi: 10.2176/nmc.oa.2018-0116

Platz JJ, Fabricant L, Norotsky M. Thoracic Trauma: Injuries, Evaluation, and Treatment. Surgical Clinics of North America. 2017;97(4):783-799. doi: 10.1016/j.suc.2017.03.004

Beshay M, Mertzlufft F, Kottkamp HW, et al. Analysis of risk factors in thoracic trauma patients with a comparison of a modern trauma centre: a mono-centre study. World Journal of Emergency Surgery. 2020;15(45):1-10. doi: https://doi.org/10.1186/s13017-020-00324-1

Harde M, Aditya G, Dave S. Prediction of outcomes in chest trauma patients using chest trauma scoring system: A prospective observational study. Indian Journal of Anaesthesia. 2019;63:194-199. doi: 10.4103/ija.IJA_750_18

McDonald SJ, Sun M, Agoston DV, Shultz SR. The effect of concomitant peripheral injury on traumatic brain injury pathobiology and outcome. J Neuroinflammation. 2016;13(1):90. doi: 10.1186/s12974-016-0555-1

Pape HC, Moore EE, McKinley T, Sauaia A. Pathophysiology in patients with polytrauma. Injury. 2022;53(7):2400-2412. doi: 10.1016/j.injury.2022.04.009

Fecher A, Stimpson A, Ferrigno L, Pohlman TH. The Pathophysiology and Management of Hemorrhagic Shock in the Polytrauma Patient. JCM. 2021;10(20):4793. doi: 10.3390/jcm10204793

Gundappa P. Extracranial Complications of Traumatic Brain Injury: Pathophysiology- A Review. Journal of Neuroanaesthesiology and Critical Care. 2019;06(03):200-212. doi: 10.1055/s-0039-1692883

Stupnytskyi M, Zhukov V, Gorbach T, Biletskii O, Kutucu H. Analysis of the early posttraumatic period pathophysiology in case of the severe combined thoracic trauma using multivariate logistic regression. CEUR-WS.org, online. 2019;2488:330-339.

Pidruchna SR, Stepanova HM, Pereviznyk BO, Vasylyshyn NA, Hudyma AA, Donchenko LS. Endogenous intoxication in animals of different age groups in case of polytrauma. Int J Med Med Res. 2016;2(2):63-66. doi: 10.11603/ijmmr.2413-6077.2016.2.7001

Tabakoglu N, Inal V. Evaluation of Basic Parameters for Prediction of ICU Mortality. Crit Intensive Care. 2021;12: 47-52. doi: 10.37678/dcybd.2021.2590

Stupnytskyi M. The pathophysiological mechanisms and the complications risk criteria of combined thoracic trauma. Kharkiv National Medical University; 2016. https://repo.knmu.edu.ua/bitstreams/2124303b-a286-450a-8873-4488fddb42f0/download. Accessed April 15, 2024.

Greenspan L, McLellan BA, Greig H. Abbreviated injury scale and injury severity score: a scoring chart. Journal of Trauma. 1985;25(1):60-64.

Champion HR, Copes WS, Sacco WJ, et al. The Major Trauma Outcome Study: establishing national norms for trauma care. Trauma. 1990;30(11):1356-1365.

Roshchin GG, Gurev SO, Mazurenko OV, et al. Standardized Systems for Assessing the Injury Severity and Status of Victims. (Teaching Manual). 2014.

Riviello ED, Kiviri W, Twagirumugabe T, et al. Hospital Incidence and Outcomes of the Acute Respiratory Distress Syndrome Using the Kigali Modification of the Berlin Definition. Am J Respir Crit Care Med. 2016;193(1):52-59. doi: 10.1164/rccm.201503-0584OC

Bewick V, Cheek L, Ball J. Statistics review 13: receiver operating characteristic curves. Critical care (London, England). 2004;8(6):508-512. doi: 10.1186/cc3000

Dogrul BN, Kiliccalan I, Asci ES, Peker SC. Blunt trauma related chest wall and pulmonary injuries: An overview. Chin J Traumatol. 2020;23(3):125-138. doi: 10.1016/j.cjtee.2020.04.003

Hajjar WM, Al-nassar SA. Chest Trauma Experience: Incidence, associated factors, and outcomes among patients in Saudi Arabia. Pak J Med Sci. 2021;37(2):373-378. doi: 10.12669/pjms.37.2.3842

Spahn DR, Bouillon B, Cerny V, Duranteau J, Filipescu D, Hunt BJ. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition. Crit Care. 2019;23(98):1-74. doi: 10.1186/s13054-019-2347-3

Surve RM, Bansal S, Muthuchellappan R. Red Blood Cell Transfusion Practices in the Neurointensive Care Unit: A Narrative Review. Journal of Neuroanaesthesiology and Critical Care. 2019;06(02):072-079. doi: 10.1055/s-0039-1685251

Izonin I, Tkachenko R, Gurbych O, Kovac M, Rutkowski L, Holoven R. A non-linear SVR-based cascade model for improving prediction accuracy of biomedical data analysis. MBE. 2023;20(7):13398-13414. doi: 10.3934/mbe.2023597

Shillan D, Sterne JAC, Champneys A, Gibbison B. Use of machine learning to analyse routinely collected intensive care unit data: a systematic review. Crit Care. 2019;23(1):284. doi: 10.1186/s13054-019-2564-9

Manay P, Satoskar RR, Karthik V, Prajapati RP. Studying Morbidity and Predicting Mortality in Patients with Blunt Chest Trauma using a Novel Clinical Score. J Emerg Trauma Shock. 2017;10 (3):128-133. doi: 10.4103/JETS.JETS_131_16

Söderlund T, Ikonen A, Pyhältö T, Handolin L. Factors associated with in-hospital outcomes in 594 consecutive patients suffering from severe blunt chest trauma. Scand J Surg. 2015;104(2):115-120. doi: 10.1177/1457496914543976

Morgan M, Vernon T, Bradburn EH, Miller JA, Jammula S, Rogers FB. A Comprehensive Review of the Outcome for Patients Readmitted to the ICU Following Trauma and Strategies to Decrease Readmission Rates. J Intensive Care Med. 2020;35(10):936-942. doi: 10.1177/0885066619899639

Downloads

Published

2025-03-30

How to Cite

Stupnytskyi, M., & Biletskyi, O. (2025). Outcome prediction criteria for multiple trauma patients with combined cranio-thoracic injuries. European Journal of Clinical and Experimental Medicine, 23(1), 110–116. https://doi.org/10.15584/ejcem.2025.1.17

Issue

Section

ORIGINAL PAPERS