Abstract
Purposes
This study aimed to clarify the prognosis of polytrauma patients presenting to the emergency department (ED) with a Glasgow Coma Scale score (GCS) of 3.
Methods
A trauma registry system has been established at our institution since 2009. The current study reviewed patients in the registry who presented to the ED with a GCS of 3 from January 2011 to December 2015. Surviving and non-surviving patients were compared to identify the prognostic factors of patient survival. The study also aimed to determine the factors contributing to patients who survived with a GCS > 13 at discharge.
Results
During the study period, 145 patients were enrolled in the study, 119 of whom (82.1%) did not survive the traumatic insult. Of the 26 survivors, 13 (9.0%) had a GCS of 14 or 15 at discharge. The multiple logistic regression revealed that a lack of bilateral dilated and fixed pupils (BFDP) (OR 5.967, 95% CI 1.780–19.997, p = 0.004) and a GCS > 3 after resuscitation (OR 6.875, 95% CI 2.135–22.138, p = 0.001) were independent prognostic factors of survival. Based on the multiple logistic regression, an age under 40 years (OR 16.405, 95% CI 1.520–177.066, p = 0.021) and a GCS > 3 after resuscitation (OR 12.100, 95% CI 1.058–138.352, p = 0.045) were independent prognostic factors of a GCS > 13 at discharge.
Conclusion
Aggressive resuscitation still provided benefit to polytrauma patients presenting with a GCS of 3, especially those with a rapid response to the resuscitation. Young patients with a deep coma on arrival had a higher probability of functional recovery after resuscitation in the ED.
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The current study was approved by Chang Gung Medical Foundation Institutional Review Broad with the reference No. 201700733B0.
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Huang, JF., Ou Yang, CH., Fu, CY. et al. Deep coma does not always predict poor outcomes among patients with polytrauma. Eur J Trauma Emerg Surg 45, 455–460 (2019). https://doi.org/10.1007/s00068-018-0917-8
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DOI: https://doi.org/10.1007/s00068-018-0917-8