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Factors Associated with In-Patient Mortality in the Rapid Assessment of Adult Earthquake Trauma Patients

Published online by Cambridge University Press:  25 April 2022

Hai Hu Open the ORCID record for Hai Hu [Opens in a new window] ,
Xiaoqin Lai ,
Chunping Tan ,
Ni Yao  and
Longping Yan
Hai Hu*
Affiliation:
Emergency Management Office of West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China; China International Emergency Medical Team (Sichuan), Chengdu City, Sichuan Province, China; Emergency Medical Rescue Base, Sichuan University, Chengdu City, Sichuan Province, China
Xiaoqin Lai
Affiliation:
Day Surgery Center, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China; China International Emergency Medical Team (Sichuan), Chengdu City, Sichuan Province, China; West China School of Nursing, Sichuan University, Chengdu City, Sichuan Province, China
Chunping Tan
Affiliation:
Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu City, Sichuan Province, China
Ni Yao
Affiliation:
Department of Critical care medicine, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China; China International Emergency Medical Team (Sichuan), Chengdu City, Sichuan Province, China; West China School of Nursing, Sichuan University, Chengdu City, Sichuan Province, China
Longping Yan
Affiliation:
West China Medical School, Sichuan University, Chengdu, Sichuan, China; West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
*
Correspondence: Hai Hu, MD No. 37. Guoxue Road Chengdu City, Sichuan Province, China E-mail: [email protected]
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Abstract

Objective:

To date, there is limited evidence for health care providers regarding the determinants of early assessment of poor outcomes of adult in-patients due to earthquakes. This study aimed to explore factors related to early assessment of adult earthquake trauma patients (AETPs).

Methods:

The data on 29,933 AETPs in the West China Earthquake Patients Database (WCEPD) were analyzed retrospectively. Then, 37 simple variables that could be obtained rapidly upon arrival at the hospital were collected. The least absolute shrinkage and selection operator (LASSO) regression analyses were performed. A nomogram was then constructed.

Results:

Nine independent mortality-related factors that contributed to AETP in-patient mortality were identified. The variables included age (OR:1.035; 95%CI, 1.027-1.044), respiratory rate ([RR]; OR:1.091; 95%CI, 1.050-1.133), pulse rate ([PR]; OR:1.028; 95%CI, 1.020-1.036), diastolic blood pressure ([DBP]; OR:0.96; 95%CI, 0.950-0.970), Glasgow Coma Scale ([GCS]; OR:0.666; 95%CI, 0.643-0.691), crush injury (OR:3.707; 95%CI, 2.166-6.115), coronary heart disease ([CHD]; OR:4.025; 95%CI, 1.869-7.859), malignant tumor (OR:4.915; 95%CI, 2.850-8.098), and chronic kidney disease ([CKD]; OR:5.735; 95%CI, 3.209-10.019).

Conclusions:

The nine mortality-related factors for ATEPs, including age, RR, PR, DBP, GCS, crush injury, CHD, malignant tumor, and CKD, could be quickly obtained on hospital arrival and should be the focal point of future earthquake response strategies for AETPs. Based on these factors, a nomogram was constructed to screen for AETPs with a higher risk of in-patient mortality.

Keywords

earthquakeleast absolute shrinkage and selection operator (LASSO)nomogramregressionrelated factortrauma
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 37 , Issue 3 , June 2022 , pp. 299 - 305
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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Footnotes

Note: Both Hai Hu and Xiaoqin Lai contributed equally to this work and should be regarded as co-first authors.

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