Admission Physiology Criteria After Injury on the Battlefield Predict Medical Resource Utilization and Patient Mortality.

摘要

Medical resources and resource allocation are of prime importance in the modern combat environment. We hypothesized that easily measurable admission physiologic criteria and injury site as well as injury severity calculated after diagnostic evaluation or surgical intervention, would be strongly correlated with resource utilization and in theater mortality outcomes. We retrospectively reviewed the Joint Theater Trauma Registry for all battlefield casualties presenting to surgical component facilities during Operation Iraqi Freedom from Jan-Jul 2004. Data were collected from battlefield casualty patients with respect to demographics, mechanism, presentation physiology (blood pressure, heart rate, temperature), base deficit, admission hematocrit, Glasgow Coma Score (GCS), Injury Severity Score (ISS), operating room utilization, blood transfusion, and mortality. Univariate and multivariate analyses were conducted to determine the degree to which admission physiology and injury severity correlated with blood utilization, necessity for operation, and acute mortality. From our analyses, easily measurable physiologic variables, including temperature, hematocrit, and base deficit, as well as the anatomic characteristics of ISS, were soundly correlated with resource utilization in the contemporary battlefield environment. In the future, the use of such predictive physiologic data could be very useful for triage and medical logistics in the resource constrained environment of war.