Independent Predictors of Early Death of Polytrauma Patients: An Analysis of 696 Patients

Polytrauma patients are at high risk to die due to acute physiological deterioration after a high injury load within the first hours. Trauma scores such as ISS, NISS and APACHE II and laboratory parameters were collected at admission. The aim of this study was to evaluate the independent predictors of early death of the polytrauma patient. A total of 696 patients (age 40.8 ± 15.5 years) who had an ISS ≥ 17 and were admitted to a trauma center within the first 24 hours after trauma were included into this retrospective study. The patients were subdivided into survivors and those who died within the first 72 hours. ISS, NISS and APACHE II score, and laboratory parameters such as lactate, prothrombin time, pH-value, hematocrite, middle arterial pressure and platelets were collected at admission time. Data were compared with Mann-Whitney test and χ2-test for proportions. The data were considered as significant if p < 0.05. Predictive ability was evaluated by using receiver operating characteristic curves. Independent predictors were analyzed by logistic regression analysis. Significantly increased values of ISS, NISS, APACHE II and serum lactate, and significantly decreased values of prothrombin time, middle arterial pressure, hematocrite, Platelets and pH-value were found in the non-survivor group (p < 0.001). APACHE II, NISS, ISS score and the prothrombin time were found to be independent predictive values of death. Early recognition of the risk of death followed by multidisciplinary resuscitation efforts could lead to a better survival rate in the population of polytrauma patients.