Independent predictors of mortality for critically ill patients with polytrauma: A single center, retrospective study

Abstract

Independent predictors of mortality and transfusion therapy in polytrauma patients from the Chinese population remain unknown. Here, we aimed to identify these predictors by retrospectively collecting and analyzing vital signs and laboratory results for 408 critically ill patients suffering from polytrauma who were treated in Affiliated Kunshan Hospital of Jiangsu University, Jiangsu Province, China from January 2020 to December 2021. We identified risk factors for mortality and transfusion therapy using logistic regression analysis. As a results, we enrolled a total of 408 polytrauma patients, with a male-to-female ratio of 2:1, a mean age of 49.02 ± 16.84 years, a mortality rate of 15.9 %, and a blood transfusion rate of 45.8 %. The multivariate logistic regression showed that decreased Glasgow Coma Scale (GCS) score (Odds ratio (OR) = 0.72, 95 % confidence interval (95%CI): 0.63–0.83, P < 0.001), decreased base excess (BE) (OR = 0.77, 95%CI: 0.67–0.87, P < 0.001), and increased Injury Severity Score (ISS) (OR = 1.12, 95%CI: 1.06–1.17, P < 0.001) were independent risk factors for the mortality. In addition, increased GCS score (OR = 1.17, 95%CI: 1.03–1.35, P = 0.020), increased heart rate (OR = 1.05, 95%CI: 1.04–1.07, P < 0.001), decreased systolic blood pressure (SBP) (OR = 0.97, 95%CI: 0.96–0.99, P < 0.001), increased peripheral oxygen saturation (SpO2) (OR = 1.10, 95%CI: 1.04–1.16, P = 0.002), decreased serum lactate (OR = 0.58, 95%CI: 0.42–0.79, P = 0.001), decreased BE (OR = 0.49, 95%CI: 0.39–0.62, P < 0.001), and increased ISS (OR = 1.25, 95%CI: 1.18–1.33, P < 0.001) were independent risk factors for blood transfusion. The area under receiver operating characteristic curves (AUROCs) of the model to predict mortality and blood transfusion were 0.976 (95%CI: 0.960–0.992, P < 0.001) and 0.973 (95%CI: 0.958–0.987, P < 0.001). In conclusion, decreased BE level was significantly associated with all-cause mortality in polytrauma patients. BE, ISS, and GCS might be independent important predictors for mortality and blood transfusion of polytrauma patients.