title: A new classification system for evaluating patients with severe trauma using B-type natriuretic peptide levels and estimated glomerular filtration rate.
abstract: Current systems for the evaluation of trauma severity are tedious and difficult to apply in an actual emergency setting. We aimed to develop and assess the accuracy of a more efficient severity evaluation system, termed the Ugawa classification, using brain-type natriuretic peptide (BNP) measurement and the estimated glomerular filtration rate (eGFR). Two-hundred trauma patients were divided into 2 groups using an eGFR cut-off value of 90ml/min/1.73m2 as an indicator of normal renal function and 2 additional groups according to whether the BNP values were greater or less than the age in years. This resulted in 4 subject groups with different combinations of eGFR and BNP. The mean SOFA score, injury severity scores (ISS), trauma and injury severity scores (TRISS), and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores of the groups were compared by Kruskal-Wallis test, and the mortality rate after 90 days was calculated. Significant intergroup differences were found in SOFA scores, ISS scores, and APACHE II-predicted mortality rates. Although no significant differences were found in the mortality rate after 90 days or TRISS-predicted mortality rate among the 4 groups, there was a trend toward increasing trauma severity from group 1 to 4. Thus, the Ugawa classification is as accurate as existing systems, has greater efficiency, and is user-friendly.
authors.affiliation: Advanced Emergency and Critical Care Center of Okayama University Hospital, Okayama 700-8558, Japan.morimorisunao@yahoo.co.jp.
authors.forename: Sunao
authors.initials: S
authors.lastname: Morisada
authors.forename: Toyomu
authors.initials: T
authors.lastname: Ugawa
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Nosaka
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Ujike
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006321:Heart / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000502:physiology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D015996:Survival Rate; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000097:blood / Q000145:classification* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain