Tiên lượng tử vong 30 ngày ở bệnh nhân đa chấn thương bằng mô hình thang điểm lâm sàng SPS

Abstract

Objective: Early prediction of mortality risk in polytrauma patients is essential for guiding treatment and optimizing resource allocation, especially during the initial emergency phase. This study aimed to develop and evaluate a simple clinical scoring system for mortality prediction following trauma. Subject and method: A retrospective study was conducted on polytrauma patients admitted to Department of Surgical and Transplant Intensive Care at 108 Military Central Hospital from January 2023 to January 2025. Initial clinical data and 30-day outcomes were analyzed using Cox regression to identify independent mortality predictors of mortality and to construct a prognostic score. Result: Three independent predictors of mortality were identified: Glasgow Coma Scale ≤ 6, traumatic shock, and prehospital cardiac arrest. A Simple Prediction Score (SPS) was constructed from these three factors; a cut-off ≥ 2 predicted mortality with a sensitivity of 68.2% and a specificity of 88.5%, while a cut-off ≥ 1 predicted mortality with a sensitivity of 95.5% and a specificity of 45.0%. The area under the ROC curve for SPS was 0.871, outperforming REMS and RTS. Conclusion: SPS is a simple score that has shown preliminary value for prehospital assessment and early mortality prediction in polytrauma patients. Further multicenter studies with larger sample sizes are needed to validate these findings.