Factors contributing to fatal outcome of XXXX : a pilot case control study.

@entity1 @entity1545 @entity131 @entity1133 @entity26 @entity772 @entity1011 @entity413 @entity130
OBJECTIVE: @entity1 with @entity131 ( @entity131 ) have a high mortality and morbidity. This pilot study was undertaken to identify contributors to outcome in the early management of @entity1 with @entity131 and to investigate the feasibility of a larger study. METHODS: Road @entity130 @entity1 who died between January 1 and April 30, 2000 were selected from the Alfred Hospital's Intensive Care @entity131 database. These @entity1 were matched with 2 survivors from the data base during the same period for age, injury severity score (ISS) and severity of @entity1545 using the head abbreviated injury score (head AIS). @entity1 injury scoring (using the revised @entity130 score, @entity130 and injury severity score and Glasgow @entity772 score), arterial blood gas analysis, lactate concentration, inspired @entity26 concentration, systolic and mean arterial blood pressure, intracranial pressure, intravenous fluid and blood transfusion volumes, body temperature, haemoglobin, white cell count, INR, APTT, temperature and plasma @entity413 , @entity1133 and @entity1011 concentrations were recorded for 48 hours from the time of injury. Time periods from the accident to key events (e.g. arrival of ambulance at accident scene, intubation, arrival at the emergency department, insertion of intracranial pressure monitor and primary surgery) were also recorded. RESULTS: Eighteen @entity1 (6 deceased, 12 survivors) were identified. Despite matching, deceased @entity1 had lower initial Glasgow @entity772 Scores (GCS) (3.6 vs. 7.4, P = 0.01) and lower revised @entity130 scores (4.41 vs. 5.75; P = 0.044) compared with survivors. There were no significant differences in other parameters. However, deceased @entity1 tended to have longer times to treatment (P = NS) and experienced @entity130 at night more frequently, and survivors received almost double the volume of fluid resuscitation during the first 12 hours (19.7 +/- 19.1 vs. 11.8 +/- 2.7 mL/kg/hr, P = 0.513). CONCLUSIONS: Both initial GCS and severity of @entity1545 should be used to match @entity131 @entity1 for injury severity in future studies. Lower initial GCS in deceased @entity1 was likely due to greater severity of @entity1545 , although it is also possible that the lower GCS was due to decreased brain perfusion (perhaps reflecting inadequate resuscitation) in these @entity1 . Volume of early fluid resuscitation, time to definitive therapy, and time of presentation to hospital may also be important determinants of @entity1 outcome. A large case control outcome study is required to extend these observations.
