Department of Emergency and Intensive Care Medicine, the Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Gusu District, Suzhou, Jiangsu, 215000, China.
BMC Emerg Med. 2024 Nov 17;24(1):216. doi: 10.1186/s12873-024-01132-5.
Trauma represents a significant global health challenge.The development of an effective scoring tool capable of predicting mortality risk in trauma cases is essential. This study aimed to investigate the combined effects of quick sequential organ failure assessment (qSOFA) and hypothermia (H) along with prothrombin time (PT) in predicting the prognosis of patients with severe trauma.
A retrospective cohort study was conducted to analyze data from severe trauma patients in the Trauma Database of the Trauma Center at the Second Affiliated Hospital of Soochow University between January 2017 and December 2021. Patients were categorized into survival and non-survival groups based on clinical outcomes. Baseline and clinical data were compared between the groups, and prognostic factors were explored using logistic regression analysis. Receiver operating characteristic (ROC) curves generated by 10-fold cross-validation using the caret in R programming language were used to assess the predictive efficacy of Injury Severity Score (ISS) and qSOFA + H + PT score for trauma patient mortality.
A total of 509 severe trauma patients (377 males and 132 females) were included, with a median age of 53 years (range: 42-65 years). The mortality rate was found to be 23.4%. Logistic regression analysis revealed that age, ISS, and qSOFA + H + PT were significant predictors of death in severe trauma patients, with odds ratios of 1.035 (95%CI:1.014-1.057), 1.052 (95%CI:1.017-1.090), and 6.124 (95%CI:3.107-12.072), respectively (P < 0.05). The predictive efficacy of ISS and qSOFA + H + PT for mortality prediction was 0.742 and 0.816, respectively.The predictive efficacy of qSOFA + H + PT for emergency blood transfusion and operation was 0.743 and 0.702.
qSOFA + H + PT are identified as significant predictors to the death of severe trauma patients. They could be utilized as early intervention indicators in emergency departments, facilitating clinical management strategies such as emergency blood transfusion, emergency operation, and prognosis prediction.
创伤是一个重大的全球健康挑战。开发一种能够预测创伤病例死亡风险的有效评分工具至关重要。本研究旨在探讨快速序贯器官衰竭评估（qSOFA）与低体温（H）联合凝血酶原时间（PT）对严重创伤患者预后的联合影响。
采用回顾性队列研究方法，分析 2017 年 1 月至 2021 年 12 月期间苏州大学附属第二医院创伤中心创伤数据库中严重创伤患者的数据。根据临床结局将患者分为存活组和非存活组。比较两组间的基线和临床数据，并使用逻辑回归分析探讨预后因素。使用 R 编程语言中的 caret 通过 10 倍交叉验证生成的受试者工作特征（ROC）曲线评估损伤严重程度评分（ISS）和 qSOFA+H+PT 评分对创伤患者死亡率的预测效能。
共纳入 509 例严重创伤患者（377 例男性和 132 例女性），中位年龄为 53 岁（范围：42-65 岁）。死亡率为 23.4%。逻辑回归分析显示，年龄、ISS 和 qSOFA+H+PT 是严重创伤患者死亡的显著预测因素，优势比分别为 1.035（95%CI：1.014-1.057）、1.052（95%CI：1.017-1.090）和 6.124（95%CI：3.107-12.072）（P<0.05）。ISS 和 qSOFA+H+PT 对死亡率预测的预测效能分别为 0.742 和 0.816。qSOFA+H+PT 对急诊输血和手术的预测效能分别为 0.743 和 0.702。
qSOFA+H+PT 是严重创伤患者死亡的显著预测因素。它们可以作为急诊科的早期干预指标，有助于制定急诊输血、急诊手术和预后预测等临床管理策略。
