title: The risk of early mortality of polytrauma patients associated to ISS, NISS, APACHE II values and prothrombin time.
abstract: BACKGROUND
  The early hemodynamic normalization of polytrauma patients may lead to better survival outcomes. The aim of this study was to assess the diagnostic quality of trauma and physiological scores from widely used scoring systems in polytrauma patients.
  
  
  METHODS
  In total, 770 patients with ISS > 16 who were admitted to a trauma center within the first 24 hours after injury were included in this retrospective study. The patients were subdivided into three groups: those who died on the day of admission, those who died within the first three days, and those who survived for longer than three days. ISS, NISS, APACHE II score, and prothrombin time were recorded at admission.
  
  
  RESULTS
  The descriptive statistics for early death in polytrauma patients who died on the day of admission, 1-3 days after admission, and > 3 days after admission were: ISS of 41.0, 34.0, and 29.0, respectively; NISS of 50.0, 50.0, and 41.0, respectively; APACHE II score of 30.0, 25.0, and 15.0, respectively; and prothrombin time of 37.0%, 56.0%, and 84%, respectively. These data indicate that prothrombin time (AUC: 0.89) and APACHE II (AUC: 0.88) have the greatest prognostic utility for early death.
  
  
  CONCLUSIONS
  The estimated densities of the scores may suggest a direction for resuscitative procedures in polytrauma patients.
  
  
  BACKGROUND
  "Retrospektive Analysen in der Chirurgischen Intensivmedizin"StV01-2008.
authors.affiliation: Division of Trauma Surgery, University Hospital of Zürich, Zurich, Switzerland.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Mica
authors.affiliation: Division of Biostatistics, University of Zürich, Zurich, Switzerland.
authors.forename: Kaspar
authors.initials: K
authors.lastname: Rufibach
authors.affiliation: University Hospital of Othopedic Surgery, Inselspital, Bern, Switzerland.
authors.forename: Marius
authors.initials: M
authors.lastname: Keel
authors.affiliation: Department of Trauma Surgery, University Hospital of Zürich, Zurich, Switzerland.
authors.forename: Otmar
authors.initials: O
authors.lastname: Trentz
keywords: APACHE II; ISS; NISS; Polytrauma; Prothrombin time