This study aimed at determining predictors of in-hospital mortality and prehospital monitoring limitations in severely injured\nintubated blunt trauma patients. We retrospectively reviewed patients� charts. Prehospital vital signs, Injury Severity Score (ISS),\ninitial Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), arterial blood gases, and lactate were compared in two study\ngroups: survivors (n = 40) and nonsurvivors (n = 30). There were no significant differences in prehospital vital signs between\ncompared groups. Nonsurvivors were older (P = 0.006), with lower initial GCS (P < 0.001) and higher ISS (P < 0.001), along\nwith higher lactate (P < 0.001) and larger base deficit (BD; ???? = 0.006), whereas RTS (P = 0.001) was lower in nonsurvivors. For\npredicting mortality, area under the curve (AUC) was calculated: for lactate 0.82 (P < 0.001), for ISS 0.82 (P < 0.001), and for\nBD 0.69 (P = 0.006). Lactate level of 3.4mmol/L or more was 82% sensitive and 75% specific for predicting in-hospital death. In\na multivariate logistic regression model, ISS (P = 0.037), GCS (P = 0.033), and age (P = 0.002) were found to be independent\npredictors of in-hospital mortality. The AUC for regression model was 0.93 (P < 0.001). Increased levels of lactate and BD on\nadmission indicate more severe occult hypoperfusion in nonsurvivors whereas vital signs did not differ between the groups.
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