Comparison of respiratory rate and peripheral oxygen saturation to assess severity in trauma patients.
OBJECTIVE
Physiological variables are important in the assessment of trauma patients. The role of respiratory rate (RR) and peripheral oxygen saturation (SpO(2)) remains a matter of debate. We therefore assessed the role of RR and SpO(2) in predicting death in trauma patients.


METHODS
Prospective analysis of a multicentric cohort of trauma patients in 2002.


METHODS
A cohort of 1,481 trauma patients cared for by a prehospital mobile intensive care unit (mean age 38 +/- 17 years, 91% blunt and 9% penetrating trauma).


METHODS
None.


RESULTS
Systolic arterial blood pressure, heart rate, Glasgow coma scale, RR and SpO(2) were recorded and the Injury Severity Score (ISS) and Trauma Related Injury Severity Score (TRISS) calculated. TRISSn was obtained by neutralizing RR. Systolic arterial blood pressure (99.9%), heart rate (99.9%), and Glasgow coma scale (99.3%) were recorded in most patients, but not RR (63%) and SpO(2) (67%). In patients with both RR and SpO(2) recording (n=675), the discrimination and calibration of TRISS was not significantly modified when RR was neutralized. Whatever the manner of expressing RR and SpO(2) (continuous, five classes, dichotomous), none was significant in predicting mortality with TRISSn. Initial SpO(2) was abnormal (< 90%) and recorded again at the hospital in 97 patients, and the proportion of patients with a non-measurable SpO(2) significantly decreased (8 vs. 42%, p < 0.001) and measurable SpO(2) markedly increased (median 99 vs. 85%, p < 0.001).


CONCLUSIONS
Respiratory rate and SpO(2) do not add significant value to other variables when predicting mortality in severe trauma patients.
University Pierre et Marie Curie (Paris 6), Department of Anesthesiology and Critical Care, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Mathieu
M
Raux
Michel
M
Thicoïpé
Eric
E
Wiel
Elisabeth
E
Rancurel
Dominique
D
Savary
Jean-Stéphane
JS
David
Frédéric
F
Berthier
Agnès
A
Ricard-Hibon
Frédéric
F
Birgel
Bruno
B
Riou
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010100:Oxygen / Q000378:metabolism*; D011446:Prospective Studies; D012119:Respiration; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000175:diagnosis*
D010100:Oxygen