Predicting Factors of Early and Late Mortality in Severe Trauma Patients Following Immediate Intervention

Strategies to prevent and provide an appropriate post-injury care system are vital save resources and reduce fatalities and disabilities. The present study aimed to evaluate risk factors for early and late mortality.

This cross-sectional study was conducted at a trauma referral center in southern Iran from June 2019 to June 2020. Based on the length of hospital stay, the patient’s outcomes were classified as short-term (within the first 48 hours of admission) or long-term (beyond 48 hours of admission) categories. Predictors of mortality evaluated included gender, age, Glasgow Coma Scale, presence of significant trauma using the Injury Severity Score, mechanism of injury, the need for intubation or chest tube placement, and hospital-acquired infection.

This study was performed on 1281 patients with a mean age of 37.9 ± 19.1 years. The median length of hospital stay was 7.7 days, with a mean injury severity score of 16.3 ± 11.3. The primary mechanism of injury was road-traffic accidents (65.5%), followed by falling (15.2%). During the first 48 hours of hospitalization, 217 of 1281 patients died or were discharged, the long-term group included 1,064. The risk factors were age≥65 years (OR=5.71, CI:3.16-10.3), GCS 9-12 (OR=3.39, CI:1.55-7.42), GCS≤8 (OR=5.88, CI:3.14-11.03) major trauma (OR=1.92, CI:1.05-3.52), and chest tube insertion (OR=2.49, CI:1.4-4.43) for short-term mortality and 45-64 age group (OR=5.95, CI:3.18-11.15), age≥65 years (OR=22.12, CI:11.38-42.97), GCS 9-12 (OR=2.9, CI:1.4-6.02), GCS≤8 (OR=5.53, CI:3.03-10.11), major trauma (OR=1.99, CI:1.11-3.54), chest tube insertion (OR=2.96, CI:1.68-5.23), and incidence of hospital-acquired infection (OR=2.42, CI:1.43-4.1) for long-term mortality.

Despite the similarities in the predictors of short-term and long-term mortality in trauma patients, our study showed that the effect of the age in these two groups varied. To improve the prognosis of unstable trauma patients, they should be categorized based on time and age.