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Simple Blood Test Can Help Predict Mortality in Trauma Patients

Some patients 58 times more likely to die than others (Jan. 18)

A simple, inexpensive blood test performed on trauma patients upon admission can help physicians identify those at greatest risk of death, according to researchers at Intermountain Medical Center in Murray, Utah.

The new study, which involved more than 9,500 patients, found that some trauma patients were up to 58 times more likely to die within a year than others, regardless of the severity of their injury.

According to the researchers, their findings provide important insights into the long-term prognosis of trauma patients — something that has not been well understood.

“The results were very surprising,” said Sarah Majercik, MD, whose team discovered that a tool developed at Intermountain Medical Center — called the Intermountain Risk Score (IRS) — can predict mortality among trauma patients.

Majercik presented the findings on January 18 at the 27th Annual Scientific Session of the Eastern Association for the Surgery of Trauma in Phoenix, Arizona.

The IRS is a computerized tool available to physicians that combines factors such as age, gender, and common blood tests — the complete blood count (CBC) and the basic metabolic profile (BMP) — to determine an individual’s mortality risk.

All of the components of the IRS tool have been helpful in evaluating individuals with medical problems, such as heart failure and chronic pulmonary disease, the authors say. But until now, the tool’s benefit had not been evaluated in trauma patients who were hospitalized because of an accident or a traumatic injury rather than because of an underlying condition.

The researchers reviewed the cases of 9,538 patients who were admitted to the hospital with trauma during a 6-year period. Using the new tool, they categorized patients according to high, moderate, and low risk levels.

The study’s findings included:

  • High-risk men were nearly 58 times more likely to die within 1 year compared with low-risk men. Men with a moderate risk were nearly 13 times more likely to die than those with low risk.
  • High-risk women were 19 times more likely to die within 1 year compared with low-risk women, and those with moderate risk were five times more likely to die than those with low risk.

Some mortality risk factors will be apparent to physicians, while others will not, the researchers say. For example, a trauma patient may look healthy apart from his or her injury, but if the IRS tool uncovers an irregular red-blood-cell distribution width — a common sign of anemia — that will increase the patient’s risk of dying.

The researchers believe their findings will provide physicians with a simple, fast way to better understand their patients’ condition, and may lead to new treatment approaches that could reduce the risk of death. The IRS has already been useful in treating patients with heart problems.

Source: Intermountain Medical Center; January 18, 2013.

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