Study The Auxiliary Assessment Methods For Advanced Trauma Life Support At Emergency Department

Objective:To study the auxiliary assessment methods for advanced trauma life support at emergency department.Methods:A retrospective study was performed including 104 emergency trauma patients,which were divided into survival group and non-survival group,in the First Hospital of China Medical University.Such clinical parameters as gender,age,heart rate?HR?, oxygen saturation?SpO₂?,mean arterial pressure?MAP?,white blood cell count?WBC?,serum creatinine?SCr?,urea nitrogen?BUN?,prothrombin time?PT?,activated partial thromboplastin time?APTT?,hemoglobin?Hb?,platelet count?PLT?,serum albumin?ALB?,fibrinogen?Fg?,glutamic-pyruvic?ALT?,total bilirubin?TBil?,Glasgow coma scale?GCS?,sequential organ failure assessment?SOFA?score and injury severity score?ISS?were recorded.The parameters which were significantly different?P<0.1?between two groups were analyzed using the logistic regression analysis to determine the independent risk factors for death at the ED.The patients were divided into two groups according to whether get the brain injury.Each group was divided into survival group and non-survival group respectively.As the same,the parameters which were significantly different?P<0.1?between two groups were analyzed using the logistic regression analysis to determine the independent risk factors for death at the ED. Receiver-operating characteristic?ROC?curves were drawn to evaluate their prognostic abilities.Results:GCS??=-0.884,OR=0.413,P=0.004?,PT??=0.260,OR=1.296,P=0.023?and SOFA score??=1.065,OR=2.901,P<0.01?were the independent risk factors for death in trauma patients at ED.For the patients with non-brain injury,the independent risk factors for death weren't be find.For the patients with brain injury,GCS??=-0.063,OR=0.510,P=0.005?,PT??=0.204,OR=1.226,P=0.029?and SOFA score??=0.097,OR=2.638,P=0.01?were still the independent risk factors for death in trauma patients at ED.The area under the ROC curves of GCS,PT and SOFA were 0.918,0.839 and 0.973respectively.Conclusion:In advanced trauma life support for the adult patients with traumatic brain injury at emergency department,GCS could be the auxiliary assessment method in primary evaluation,while SOFA score and PT could be the auxiliary assessment methods in secondary evaluation.