title: A predictive model of early mortality in trauma patients.
abstract: BACKGROUND
  Rapid thrombelastography (rTEG) is a real-time whole-blood viscoelastic coagulation assay. We hypothesized that admission rTEG and clinical data are independent predictors of trauma-related mortality.
  
  
  METHODS
  Prospective observational data (patient demographics, admission vital signs, laboratory studies, and injury characteristics) from trauma patients enrolled within 6 hours of injury were collected. Mann-Whitney U test and analysis of variance test assessed significance (P ≤ .05). Logistic regression analyses determined the association of the studied variables with 24-hour mortality.
  
  
  RESULTS
  Seven hundred ninety-five trauma patients were enrolled, of which 55 died within 24 hours of admission. Admission variables which independently predicted 24-hour mortality were as follows: Glasgow Coma Scale ≤8, hemoglobin <11 g/dL, international normalized ratio >1.5, Ly30 >8%, and penetrating injury (P < .05). This 5-variable model's area under the receiver operator characteristic curve was .88. The Hosmer-Lemeshow goodness-of-fit test was .90.
  
  
  CONCLUSIONS
  This 5-variable model provides a rapid prediction of 24-hour mortality. The inclusion of rTEG Ly30 demonstrates the association of fibrinolysis with outcome and may support the early use of antifibrinolytic therapies.
authors.affiliation: Department of Trauma, Critical Care, and Acute Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA. Electronic address: hampton@ohsu.edu.
authors.forename: David A
authors.initials: DA
authors.lastname: Hampton
authors.affiliation: Department of Trauma, Critical Care, and Acute Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA.
authors.forename: Tim H
authors.initials: TH
authors.lastname: Lee
authors.affiliation: Department of Trauma, Critical Care, and Acute Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Diggs
authors.affiliation: Department of Trauma, Critical Care, and Acute Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA.
authors.forename: Sean P
authors.initials: SP
authors.lastname: McCully
authors.affiliation: Department of Trauma, Critical Care, and Acute Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Schreiber
mesh_terms: D000328:Adult; D003661:Decision Support Techniques; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D013916:Thrombelastography; D014947:Wounds and Injuries / Q000097:blood / Q000401:mortality*
keywords: Model; Mortality; Thrombelastography; Trauma