COMORBIDITY, OUTCOMES, AND PREDICTORS OF IN-HOSPITAL MORTALITY IN A LEVEL I TRAUMA CENTER

Objectives: Among the aging population, the trauma burden among the adult patient population is expected to grow dramatically. This study aims to determine clinical outcomes and comorbid predictors of in-hospital mortality in adult trauma.

Methods: This is a single-center study of Trauma Registry data from July 1, 2016, to February 28, 2022. The inclusion criteria were based on age (≥18 years). A logistic regression was performed to ascertain the effects of predictor variables on the likelihood that an adult trauma patient will experience in-hospital mortality.

Results: 19321 patients (mean age 59) were included in the analysis based on the methods section's requirements; 541 (2.8%) experienced in-hospital mortality. The logistic regression model was statistically significant (N=5297, p< 0.01). The model explained 73% (Nagelkerke R2) of the variance with in-hospital mortality and correctly classified 70% of cases (alpha .05). Several significant risk factors for in-hospital mortality include pre-hospital cardiac arrest (OR=21.85; p<.01); increasing injury severity score (OR=1.14, p<.01); increasing ICU length of stay (OR=3.31, p<.01); and preexisting COPD (OR=3.41, p=.05), and anticoagulant therapy (OR=5.81; p<.01).

Conclusion: Specific preexisting medical conditions were associated with increased mortality after trauma, regardless of increasing age. Knowledge of the relevant identified risk profile in mortality could aid the trauma team in better assessing clinical decision-making in care.