Erschienen in:
01.03.2006 | Original
Comparison of respiratory rate and peripheral oxygen saturation to assess severity in trauma patients
verfasst von:
Mathieu Raux, Michel Thicoïpé, Eric Wiel, Elisabeth Rancurel, Dominique Savary, Jean-Stéphane David, Frédéric Berthier, Agnès Ricard-Hibon, Frédéric Birgel, Bruno Riou
Erschienen in:
Intensive Care Medicine
|
Ausgabe 3/2006
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Abstract
Objective
Physiological variables are important in the assessment of trauma patients. The role of respiratory rate (RR) and peripheral oxygen saturation (SpO2) remains a matter of debate. We therefore assessed the role of RR and SpO2 in predicting death in trauma patients.
Design
Prospective analysis of a multicentric cohort of trauma patients in 2002.
Patients
A cohort of 1,481 trauma patients cared for by a prehospital mobile intensive care unit (mean age 38 ± 17 years, 91% blunt and 9% penetrating trauma).
Results
Systolic arterial blood pressure, heart rate, Glasgow coma scale, RR and SpO2 were recorded and the Injury Severity Score (ISS) and Trauma Related Injury Severity Score (TRISS) calculated. TRISSn was obtained by neutralizing RR. Systolic arterial blood pressure (99.9%), heart rate (99.9%), and Glasgow coma scale (99.3%) were recorded in most patients, but not RR (63%) and SpO2 (67%). In patients with both RR and SpO2 recording (n = 675), the discrimination and calibration of TRISS was not significantly modified when RR was neutralized. Whatever the manner of expressing RR and SpO2 (continuous, five classes, dichotomous), none was significant in predicting mortality with TRISSn. Initial SpO2 was abnormal (< 90%) and recorded again at the hospital in 97 patients, and the proportion of patients with a non-measurable SpO2 significantly decreased (8 vs. 42%, p < 0.001) and measurable SpO2 markedly increased (median 99 vs. 85%, p < 0.001).
Conclusion
Respiratory rate and SpO2 do not add significant value to other variables when predicting mortality in severe trauma patients.