title: Prognostic factors associated with mortality in patients with severe trauma: from prehospital care to the Intensive Care Unit.
abstract: OBJECTIVE
  To identify factors related to mortality in adult trauma patients, analyzing the clinical, epidemiological and therapeutic characteristics at the pre-hospital levels, in the Emergency Care Department and in Intensive Care.
  
  
  METHODS
  A retrospective, longitudinal descriptive study was carried out. Statistical analysis was performed using SPSS, MultBiplot and data mining methodology.
  
  
  METHODS
  Adult multiple trauma patients admitted to the Salamanca Hospital Complex (Spain) from 2006 to 2011.
  
  
  METHODS
  Demographic variables, clinical, therapeutic and analytical data from the injury site to ICU admission. Evolution from ICU admission to hospital discharge.
  
  
  RESULTS
  A total of 497 patients with a median age of 45.5 years were included. Males predominated (76.7%). The main causes of injury were traffic accidents (56.1%), precipitation (18.4%) and falls (11%). The factors with the strongest association to increased mortality risk (P<.05) were age > 65 years (OR 3.15), head injuries (OR 3.1), pupillary abnormalities (OR 113.88), level of consciousness according to the Glasgow Coma Scale ≤ 8 (OR 12.97), and serum lactate levels > 4 mmol/L (OR 9.7).
  
  
  CONCLUSIONS
  The main risk factors identified in relation to the prognosis of trauma patients are referred to the presence of head injuries. Less widely known statistical techniques such as data mining or MultBiplot also underscore the importance of other factors such as lactate concentration. Trauma registries help assess the healthcare provided, with a view to adopting measures for improvement.
authors.affiliation: Unidad de Cuidados Intensivos, Complejo Hospitalario de Salamanca, Salamanca, España. Electronic address: jagrobledo@yahoo.es.
authors.forename: J
authors.initials: J
authors.lastname: González-Robledo
authors.affiliation: Unidad de Cuidados Intensivos, Complejo Hospitalario de Salamanca, Salamanca, España.
authors.forename: F
authors.initials: F
authors.lastname: Martín-González
authors.affiliation: Cuidados Intensivos, Universidad de Salamanca, Salamanca, España.
authors.forename: M
authors.initials: M
authors.lastname: Moreno-García
authors.affiliation: Cuidados Intensivos, Universidad de Salamanca, Salamanca, España.
authors.forename: M
authors.initials: M
authors.lastname: Sánchez-Barba
authors.affiliation: Cuidados Intensivos, Universidad de Salamanca, Salamanca, España.
authors.forename: F
authors.initials: F
authors.lastname: Sánchez-Hernández
mesh_terms: D000058:Accidental Falls / Q000401:mortality; D000059:Accidents / Q000401:mortality*; D000063:Accidents, Traffic / Q000401:mortality; D000328:Adult; D000367:Age Factors; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000401:mortality / Q000628:therapy; D003128:Coma / Q000453:epidemiology / Q000209:etiology; D003422:Critical Care; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D005260:Female; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D011681:Pupil Disorders / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D015599:Trauma Severity Indices
keywords: Critical care; Cuidados intensivos; Lactate; Lactato; Politraumatismos; Polytraumatism; Population registry; Registros de población