The BIG Score and In-Hospital Trauma Mortality (BIGstd)

Haseki Training and Research Hospital

Status: Completed

Conditions: Injury Traumatic; Multiple Trauma

Treatments: Other: BIG SCORE; Other: Injury Severity Score; Other: Glasgow coma scale; Other: Revised Trauma Score

Study type: Observational

Funder types: Other

Identifiers

NCT06574464

2023-202

Details and patient eligibility

About

This study investigated the efficacy and reliability of the BIG score, calculated based on the base deficit (BD), International Normalized Ratio (INR), and Glasgow coma scale (GCS), in comparison with the GCS, Revised trauma score (RTS), and Injury Severity Score (ISS) for predicting in-hospital mortality in adults with multiple-trauma presenting to the emergency department (ED).

Full description

This retrospective, observational, single-center study included 563 consecutive adults (≥ 18 years old) with multiple trauma who were admitted to our emergency department and hospitalized between January 2022 and December 2023. We assessed patient demographics (age and sex), vital signs on admission (systolic blood pressure [SBP, mmHg], heart rate [HR, beats/min], respiratory rate [RR, breaths/min], and peripheral oxygen saturation [SpO2, %]), complaints and symptoms on admission, anatomic region of injury, type of trauma (blunt or penetrating), mechanism of injury, BD measured in blood gases, INR, trauma scoring systems (e.g., GCS, RTS, ISS, and BIG score), and clinical outcomes (discharge, hospitalization, or death). The study cohort was divided into survivors and non-survivors. Survivors were defined as patients who were still alive after 28 days, while non-survivors had passed away within that time. The demographics, clinical characteristics, and trauma scoring systems were compared between survivors and non-survivors to determine the prognosis of patients with multiple trauma. Independent predictors of mortality were determined by multivariate logistic regression analysis of variables (demographic characteristics, clinical characteristics, and trauma scores) that differed significantly between survivors and non-survivors. Receiver operating characteristic (ROC) curve analysis was performed to establish cut-off values for the GCS, RTS, ISS, and BIG score, and then to assess the sensitivity and specificity of these scoring systems in terms of predicting in-hospital mortality.

Enrollment: 563 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• This study included 563 consecutive adults (≥ 18 years old) with multiple trauma who were admitted to our Emergency Department and hospitalized between January 2022 and December 2023.

Exclusion criteria

• Patients aged < 18 years and adults who were discharged from the Emergency Department
• Patients with non-traumatic injuries and those who presented to the Emergency Department for reasons other than trauma
• Patients with missing Base Deficit and International Normalized Ratio levels
• Patients who had been admitted to the hospital more than 24 hours after the trauma
• Patients with single trauma (e.g., isolated extremity trauma, isolated head injury, etc.)
• Patients with chronic conditions such as chronic renal failure or hepatic, hematological, or neurological diseases

Trial design

563 participants in 2 patient groups

Survivors

Description:

Survivors were defined as patients who were still alive after 28 days of admission to the emergency department.

Treatment:

Other: Revised Trauma Score

Other: Glasgow coma scale

Other: Injury Severity Score

Other: BIG SCORE

Non-survivors

Description:

Non-survivors had passed away within 28 days of admission to the emergency department

Treatment:

Other: Revised Trauma Score

Other: Glasgow coma scale

Other: Injury Severity Score

Other: BIG SCORE