Clarke et al reported predictors of mortality for a trauma patient with intra-abdominal bleeding. The authors are from Hahnemann University, University of Pennsylvania, and Drexel University in Philadelphia.
Patient selection: trauma with major intra-abdominal trauma with bleeding
Predictors of mortality:
(1) increasing hypotension on admission (systolic blood pressure <= 90)
(2) increasing time in the Emergency Department prior to emergency laparotomy, up until 90 minutes.
After 90 minutes the risk decreases. This may reflect less severe bleeding.
Mortality increases 0.35% per minute or about 1% every 3 minutes, up to 90 minutes.
probability of mortality based on time in ED =
= 1% * (minutes in ED up to 90 minutes) / 3
The risk further increases based on the extent of hypotension upon arrival.
Increasing time to arrive to the Emergency Department also impacted survival.
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