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Open Access

Prognostic predictors of early mortality from exsanguination in adult trauma: a Malaysian trauma center experience

Tan Jih Huei, Yuzaidi Mohamad, Henry Tan Chor Lip, Norazlin Md Noh, Rizal Imran Alwi
DOI: 10.1136/tsaco-2016-000070 Published 31 May 2017
Tan Jih Huei
1 Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
2 Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Malaysia
3 Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
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Yuzaidi Mohamad
1 Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
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Henry Tan Chor Lip
1 Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
2 Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Malaysia
3 Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
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Norazlin Md Noh
1 Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
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Rizal Imran Alwi
1 Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
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  • Figure 1
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    Figure 1

    Injuries according to anatomic location.

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    Figure 2

    Death within 72 hours by anatomic location.

Tables

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  • Table 1

    Comparison of physiological parameters between early death from exsanguination and death from non-exsanguination/survivors

    Early death from exsanguination (n=58)
    Mean (SD)
    Death from non-exsanguination/survivors (n=2150)
    Mean (SD)
    p Value
    Age38.83 (18.259)35.62 (16.129)0.137
    SBP108.26 (29.348)125.38 (25.338)<0.001
    RR23.03 (11.039)20.51 (5.654)0.001
    HR103.40 (30.894)92.94 (30.591)0.010
    Temp36.824 (.3175)36.966 (.2614)<0.001
    GCS11.29 (4.213)13.34 (2.749)<0.001
    • GCS, Glasgow Coma Scale; HR, heart rate; RR, respiratory rate; SBP, systolic blood pressure; Temp, temperature.

  • Table 2

    OR for death according to body regions

    Body regionsEarly death from exsanguination (n=58), n (%)OR (95% CI)p Value
    Abdominal32 (55.2%)3.948 (2.331 to 6.686)<0.001
    Thoracic39 (67.2%)1.180 (0.677 to 2.057)0.558
    Head and neck16 (27.6%)1.380 (0.769 to 2.478)0.278
    Extremity16 (27.6%)0.619 (0.346 to 1.108)0.103
    Face3 (5.2%)0.367 (0.114 to 1.182)0.080
  • Table 3

    OR for death comparing early death from exsanguination and death from non-exsanguination/survivors with NISS, RTS and TRISS

    ScoresEarly death from exsanguination (n=58)
    Mean (SD)
    Death from non-exsanguination/survivors (n=2150)
    Mean (SD)
    p Value
    NISS38.24 (13.925)18.89 (13.663)<0.001
    RTS6.0341 (1.77148)7.4199 (0.93834)<0.001
    TRISS0.76693 (0.283329)0.92084 (0.122104)<0.001
    •  NISS, New Injury Severity Score; RTS, Revised Trauma Score; TRISS, Trauma and Injury Severity Score.

  • Table 4

    Multivariate analysis for the predictors of early death from exsanguination

    exp(B)95% CI for exp(B)p Value
    Age1.0261.009 to 1.0440.002
    SBP0.9850.975 to 0.9950.003
    RR1.0210.988 to 1.0550.211
    HR1.0040.997 to 1.0110.257
    Temperature0.2030.076 to 0.5430.001
    GCS0.9380.870 to 1.0110.094
    Abdominal injury3.5471.964 to 6.4090.000
    NISS1.0631.044 to 1.0830.000
    • Nagelkerke’s R2=0.271.

    • GCS, Glasgow Coma Scale; HR, heart rate; NISS, New Injury Severity Score; RR, respiratory rate; SBP, systolic blood pressure.

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Prognostic predictors of early mortality from exsanguination in adult trauma: a Malaysian trauma center experience
Tan Jih Huei, Yuzaidi Mohamad, Henry Tan Chor Lip, Norazlin Md Noh, Rizal Imran Alwi
Trauma Surg Acute Care Open May 2017, 2 (1) e000070; DOI: 10.1136/tsaco-2016-000070

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Prognostic predictors of early mortality from exsanguination in adult trauma: a Malaysian trauma center experience
Tan Jih Huei, Yuzaidi Mohamad, Henry Tan Chor Lip, Norazlin Md Noh, Rizal Imran Alwi
Trauma Surg Acute Care Open May 2017, 2 (1) e000070; DOI: 10.1136/tsaco-2016-000070
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Prognostic predictors of early mortality from exsanguination in adult trauma: a Malaysian trauma center experience
Tan Jih Huei, Yuzaidi Mohamad, Henry Tan Chor Lip, Norazlin Md Noh, Rizal Imran Alwi
Trauma Surgery & Acute Care Open May 2017, 2 (1) e000070; DOI: 10.1136/tsaco-2016-000070
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