Factors related to early and rapid assessment of in-hospital mortality among older adult trauma patients in an earthquake

Abstract

BACKGROUND: There is limited evidence for emergency physicians and emergency trauma surgeons regarding the determinants of early and rapid assessment of older adult in-hospital mortality due to earthquakes. This study explored factors related to the early and rapid assessment of the mortality among older adult earthquake trauma patients (OAETPs) and created a screening model. METHODS: Data on 7,308 OAETPs from the West China Earthquake Patients Database were analyzed retrospectively. The 35 variables that can be obtained rapidly on arrival at the hospital were collected. Least absolute shrinkage and selection operator (LASSO) regression analysis was performed. Then, the nomogram for assessing the mortality of OAETPs was constructed. RESULTS: We identified 10 independent mortality-related factors that contributed to the in-hospital mortality of OAETPs. The 10 factors included age (odds ratio [OR]=1.061, 95% confidence interval [CI]:1.031–1.090), dementia (OR=5.146, 95%CI: 1.169–17.856), coronary heart disease (CHD; OR=23.441, 95%CI: 4.799–83.927), malignant tumor (OR=8.497, 95%CI: 3.583–17.967), deep vein thrombosis (DVT; OR=7.110, 95%CI: 1.369–27.168), chronic kidney disease(CKD; OR=11.783, 95%CI: 5.419–24.407), pulse rate (PR; OR=1.036, 95%CI: 1.022–1.048), mean artery pressure (MAP; OR=0.960, 95%CI: 0.945–0.975), Glasgow Coma Scale (GCS; OR=0.864, 95%CI: 0.760–0.972), and Triage Revised Trauma Score (T-RTS, OR=0.485, 95%CI: 0.351–0.696). CONCLUSION: The 10 mortality-related factors could be quickly obtained on hospital arrival and should be the focal point of future earthquake response strategies regarding hospitalized older adults with trauma. A nomogram was constructed based on the factors for screening OAETPs with a higher risk of in-hospital mortality.