Retrospective evaluation of multitrauma patients applying to the emergency department

Retrospective Evaluation of Multitrauma Patients Applying to the Emergency Department Aim: In this study, it was aimed to retrospectively evaluate the clinical characteristic and risk factors affecting mortality in multitrauma patients admitted to the emergency department. Methods: This cross-sectional study was carried out in the Emergency Department of Uşak Training and Research Hospital, between 1 January 2018 and 30 April 2022. Patients (n = 188) hospitalized from the emergency department to the anesthesia intensive care unit (ICU) due to multitrauma at these dates were included in the study. The clinical characteristics, revised trauma score (RTS), Glaskow coma scale (GCS), and shock index were recorded. Results: 75% of the cases were male and the mean age was 45.55 ± 19.29 years. The most common types of trauma were traffic accidents 61.7% and fall injuries 10.6%. The most common injuries are thoracic region injuries; 47.1% rib fracture, 41.5% lung contusion, 29.8% pneumothorax and hemothorax. The general condition of 20.2% of the cases was poor, 11.2% of them were unconscious and 6.9% of them died. When the risk factors affecting mortality were evaluated by multivariate analysis: it was determined that intubating the cases (OR: 20.068 [95%CI: 0.941 - 136.959], p = 0.002) and high lactate level (OR: 1.316 [95%CI: 1.051 - 1.647], p = 0.017) increased the risk of mortality independently of other variables. Respiratory rate, the parameter with the highest sensitivity in predicting mortality, was able to predict mortality with a sensitivity of 76.9% and a specificity of 69.1% at a cut-off point of <15 (AUC: 0.763 [95%CI: 0.608-0.918], p = 0.002). The parameter with the highest specificity, GCS, was able to predict mortality with a sensitivity of 53.8% and a specificity of 94.3% at a cut-off point of <8 (AUC: 0.669 [95%CI: 0.475-0.894], p = 0.042). Conclusion: Among the cases who applied to the emergency department due to multitrauma, those with higher lactate levels and those who were intubated had a higher mortality risk. In these cases, the frequency of mortality and morbidity can be reduced by taking more serious precautions in the early period and by appropriate treatment management. Keywords: Multitrauma, Emergency Service, Intensive Care Unit, Mortality