Factors Predicting outcome of patients with polytrauma in tertiary center of western Nepal

Authors

  • Pradeep Ghimire Manipal Teaching Hospital, Pokhara, Nepal https://orcid.org/0000-0002-7104-8517
  • Nikunja Yogi Manipal Teaching Hospital, Pokhara
  • Balgopal Karmacharya Manipal Teaching Hospital, Pokhara
  • Abhishek Poudel Manipal Teaching Hospital, Pokhara
  • Sushil Mishra Manipal Teaching Hospital, Pokhara

DOI:

https://doi.org/10.3126/jbsfn.v2i1.39005

Keywords:

Glasgow coma scale, Polytrauma, Injury severity score, Glasgow outcome scale

Abstract

 Introduction: Trauma is a public health issue associated with substantial socioeconomic impacts and major adverse clinical outcomes. No single study has previously investigated the predictors of mortality in a general trauma population. In this study, we assessed different clinico-biochemical parameters to investigate the associations between those parameters and their effects in outcome of a polytrauma patient.

Methods: An analytical study was done in between January 2020 to December 2020 in patients with polytrauma admitted to intensive care unit Department of Surgery in Manipal Teaching Hospital to assess the effect of various socio-demographic and clinic-radiologic variables in outcome (Glasgow outcome scale) of polytrauma patients. All the categorical data were tested using chi square test or Fischer Exact test and continuous variables were tested using student’s “t” test. P value <0.05 was determined significant. Those independent variables significant on univariate analysis were then subjected to binary logistic regression and the data was presented as level of significance, odds ratio and 95% confidence interval. Analysis was done using SPSS 23.0.

Results: Out of 67 patients, 34 had favorable GOS and 33 had unfavorable GOS. Injury Severity Score (ISS) (P<0.01), abnormal pupils (P<0.01), RBS (0.04), low GCS during presentation (<0.01), higher CT Marshal Grade (0.01) had strong associations with unfavorable outcome in polytraumatic patient. ISS was the only significant parameter when all the other significant variables were kept constant in binary logistic regression model (OR=1.18, 95% CI=1.08-1.28).

Conclusion: Injury Severity Score, abnormal pupils during presentation, high level of blood sugar after polytrauma, low GCS during presentation, higher CT Marshal Grade are strong predictors in outcomes of polytraumatic patient.

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Author Biographies

Pradeep Ghimire, Manipal Teaching Hospital, Pokhara, Nepal

Associate Professor and Head, Department of Surgery

Nikunja Yogi, Manipal Teaching Hospital, Pokhara

Associate Professor

Department of Neurosurgery

Balgopal Karmacharya, Manipal Teaching Hospital, Pokhara

Associate Professor and Head

Department of Neurosurgery

Abhishek Poudel, Manipal Teaching Hospital, Pokhara

Resident

Department of Surgery

Sushil Mishra, Manipal Teaching Hospital, Pokhara

Resident

Department of Surgery

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Published

2021-08-10

How to Cite

Ghimire, P., Yogi, N., Karmacharya, B., Poudel, A., & Mishra, S. (2021). Factors Predicting outcome of patients with polytrauma in tertiary center of western Nepal. Journal of Brain and Spine Foundation Nepal, 2(1), 13–18. https://doi.org/10.3126/jbsfn.v2i1.39005

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Section

Original Articles