Predictive Model for Multiple Trauma Patients Based on Anatomical Location of Injury at RSSA Malang, Indonesia: A Sub-Study in the Development of a Multicomponent Model
Research
DOI:
https://doi.org/10.55175/cdk.v52i9.1316Keywords:
Head injury, prognosis, multiple traumaAbstract
Introduction: Management of trauma still poses a challenge in Indonesia without significant improvement in mortality rates in the last 12 years, especially in multiple trauma involving at least 2 organ systems. This study aims to predict the prognosis of multiple trauma patients treated at Saiful Anwar Hospital (RSSA) Malang based on the anatomical location of the injury. Methods: Retrospective cohort study of 506 multiple trauma patients in RSSA during 2021-2022. The analyses used a chi square test and logistic regression test to obtain a regression equation. Results: Multiple trauma cases in RSSA were dominated by males in productive age (15-54 years). Head injury was the most influential variable in predicting the prognosis of multiple trauma patients in hospital, followed by thoracic injury, spinal injury, and abdominal injury. The logistic regression model was quite capable of explaining the data (p=0.931; Hosmer-Lameshow test), while the area under the curve (AUC-ROC) for prognosis in hospital care from this equation was 0.706 with a 95% confidence interval of 0.653-0.759 (good category). Conclusion: Head injuries, thoracic injuries, abdominal injuries, and spinal injuries are predictors of mortality of trauma cases in hospital care in RSSA, Malang, Indonesia.
Downloads
References
Badan Pusat Statistik. Mortalitas di Indonesia hasil long form sensus penduduk 2020 [Internet]. Badan Pusat Statistik. 2020. Available from: https://indonesia.unfpa.org/sites/default/files/pub-pdf/mortalitas-di-indonesia-hasil-long-form-sensus-penduduk-2020.pdf.
Sulistiyowati N, Senewe FP. Pola penyebab kematian usia produktif (15-54 tahun). Jurnal Kesehatan Reproduksi 2014;5(1):37-47.
Redaksi AJNN. Jumlah kasus kecelakaan lalu lintas di Indonesia, tertinggi kecelakaan motor. AJNN [Internet]. 2022 Feb;1–2. Available from: https://www.ajnn.net/news/jumah-kasus-kecelakaan-lalu-lintas-di-indonesia-tertinggi-kecelakaan-motor/index.html.
World Health Organization. Guidelines for trauma quality improvement programmes [Internet]. Geneva: World Health Organization; 2009. p. 1–114. Available from: https://iris.who.int/bitstream/handle/10665/44061/9789241597746_eng.pdf;sequence=1.
Munjin M. Trauma pathology management of multiple trauma patients [Internet]. Vol. 1. Switzerland: AOSPINE; 2020 .p. 1–20. Available from: https://www.aolatam.org/ftp/edudatabase/open-files/Management_of_multiple_trauma_patient_new.pdf.
de Macedo Filho L, Figueredo LF, Villegas-Gomez GA, Arthur M, Pedraza-Ciro MC, Martins H, et al. Pathophysiology-based management of secondary injuries and insults in TBI. Biomedicines 2024;12(3):1–18. doi: 10.3390/biomedicines12030520.
Alharbi RJ, Lewis V, Miller C. International perspectives of prehospital and hospital trauma services: a literature review. Trauma Care 2022;2(3):445–62. doi: 10.3390/traumacare2030037.
Callcut RA, Kornblith LZ, Conroy AS, Robles AJ, Meizoso JP, Namias N, et al. The why and how our trauma patients die: a prospective multicenter Western trauma association study. J Trauma Acute Care Surg. 2019;86(5):864–70. doi: 10.1097/TA.0000000000002205.
Iyengar KP, Venkatesan AS, Jain VK, Shashidhara MK, Elbana H, Botchu R. Risks in the management of polytrauma patients: clinical insights. Orthop Res Rev. 2023;15(March):27–38. doi: 10.2147/ORR.S340532.
Kemenkes. Peraturan Menteri Kesehatan Nomor 19 Tahun 2016 tentang Sistem Penanggulangan Gawat Darurat Terpadu. Berita Negara Republik Indonesia; 2016 .p. 1–17.
Wibowo D, Setyobudihono S, Lestia S. Literature review faktor-faktor penghambat pelayanan gawat darurat. Dinamika Kesehatan: J Kebidanan dan Keperawatan. 2023;14(1):43–55.
Prasetya E, Winarni I, Haedar A. Studi fenomenologi: pengalaman perawat di lingkungan tempat kejadian trauma akut di prehospital kota Malang. J Med Respati. 2015;X(4):21–9.
Tourtier JP. Trauma patients with normal vital signs: is shock index a reflection of injury severity? Crit Care Med. 2010 Nov;38(11):2269. doi: 10.1097/CCM.0b013e3181f17d97.
Heffernan DS, Thakkar RK, Monaghan SF, Ravindran R, Adams CA, Kozloff MS, et al. Normal presenting vital signs are unreliable in geriatric blunt trauma victims. J Trauma. 2010 Oct;69(4):813-20. doi: 10.1097/TA.0b013e3181f41af8.
Nakaharaa S, Yokota J. Revision of the international classification of diseases to include standardized descriptions of multiple injuries and injury severity. Bull World Heal Organ. 2011;89(March):238–40. doi: 10.2471/BLT.10.078964.
Lee SY, Cheon YJ, Han C. Comparison prehospital RTS (revised trauma score) with hospital RTS in trauma severity assessment. J Trauma Inj. 2015;28(3):177–81. doi: 10.20408/jti.2015.28.3.177.
Messelu MA, Tilahun AD, Beko ZW, Endris H, Belayneh AG, Tesema GA. Incidence and predictors of mortality among adult trauma patients admitted to the intensive care units of comprehensive specialized hospitals in Northwest Ethiopia. Eur J Med Res. 2023;28(1):1–12. doi: 10.1186/s40001-023-01056-z.
Papadimitriou-Olivgeris M, Panteli E, Koutsileou K, Boulovana M, Zotou A, Marangos M, et al. Predictors of mortality of trauma patients admitted to the ICU: a retrospective observational study. Brazilian J Anesthesiol (English Edition) 2021;71(1):23–30. doi: 10.1016/j.bjane.2020.12.006.
Kunitake RC, Kornblith LZ, Cohen MJ, Callcut RA. Trauma early mortality prediction tool (TEMPT) for assessing 28-day mortality. Trauma Surg Acute Care Open. 2018;3(1):1–6. doi: 10.1136/tsaco-2017-000131.
Anwar MAF, Atmoko WD, Hari Wujoso. Gambaran trauma kepala korban mati kecelakaan lalu lintas yang ditangani instalasi forensik RSUD Dr. Moewardi tahun 2017-2022. Plex Med J. 2024;3(1):8–15. doi: 10.20961/plexus.v3i1.1026.
American College of Surgeons. ATLS advanced trauma life support. Chicage: American College of Surgeons;2018. p. 1-474.
Soesanto H, Tangkilisan A, Lahunduitan I. Thorax trauma severity score sebagai prediktor acute respiratory distress syndrome pada trauma tumpul toraks. J Biomedik. 2018;10(1):34–8. doi: 10.35790/jbm.10.1.2018.18999.
Helsloot D, Fitzgerald MC, Lefering R, Verelst S, Missant C. The first hour of trauma reception is critical for patients with major thoracic trauma: a retrospective analysis from the TraumaRegister DGU. Eur J Anaesthesiol. 2023;40(11):865–73. doi: 10.1097/EJA.0000000000001834.
Gonultas F, Kutluturk K, Gok AFK, Barut B, Sahin TT, Yılmaz S. Analysis of risk factors of mortality in abdominal trauma. Ulus Travma ve Acil Cerrahi Derg. 2020;26(1):43–9. doi: 10.14744/tjtes.2019.12147.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Ari Prasetyadjati, Nanik Setijowati, Istan Irmansyah Irsan, Munsifah Zaiyanah, Willy Johan
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
