Joseph Hill MSN, APRN, FNP-C, CFRN, CMTE , Jeremy Norman MBA, NRP, FP-C , M. David Gothard MS , Michelle M. McLean MD , Deanne Krajkowski BS CTRS , Bethany Figg Ded.T, MBA, MLIS, C-TAGME, AHIP , Jeff Marr FP-C
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引用次数: 0
Abstract
Objective
Stress-induced hyperglycemia is a well-established risk factor for mortality in critically ill trauma patients. Limited research exists on prehospital diagnostic tools for predicting hemorrhagic shock and mortality in this population.
Methods
A retrospective study involving 435 adult and pediatric trauma patients transported by air ambulance in 13 years aimed to assess the predictive value of prehospital point-of-care glucose (POCG), shock index (SI), Glasgow Coma Scale (GCS), fluid administration, and reverse SI multiplied by GCS (rSIG) for 24-hour and 30-day mortalities.
Results
Univariate analyses revealed that an elevated SI and lower GCS were associated with increased mortality, whereas POCG and crystalloid fluid administration were not significant predictors. Multivariate analysis confirmed SI and GCS as independent predictors of 30-day mortality. The rSIG emerged as the strongest predictor, with an Area Under the Receiver Operating Characteristic curve (AUROC) of 0.872. POCG alone did not demonstrate statistical significance in predicting mortality.
Conclusion
Prehospital SI and GCS are valuable predictors of mortality, with rSIG offering the highest predictive accuracy. Despite limitations, this study suggests the potential impact of prehospital markers on trauma-related outcomes, emphasizing the need for further research validation.
期刊介绍:
Air Medical Journal is the official journal of the five leading air medical transport associations in the United States. AMJ is the premier provider of information for the medical transport industry, addressing the unique concerns of medical transport physicians, nurses, pilots, paramedics, emergency medical technicians, communication specialists, and program administrators. The journal contains practical how-to articles, debates on controversial industry issues, legislative updates, case studies, and peer-reviewed original research articles covering all aspects of the medical transport profession.