Predictive Factors for Systemic Inflammatory Response in Trauma Patients
Keywords:
age, comorbidity, substance use, trauma, MEWS, SIRSAbstract
Abstract:
Objective: To study the predictive power of age, comorbidity, substance use, and severity of physiological change on trauma patients’ systemic inflammatory response syndrome.
Design: Descriptive predictive study.
Methodology: The sample consisted of 147 conscious trauma patients admitted to hospital within 24 to 72 hours after injury, with 15 points on the Glasgow Scale. Data gathering instruments were a demographic data form, a comorbidity evaluation form, a substance use evaluation form, the Modifed Early Warning Score (MEWS), and the Systemic Inflammatory Response Syndrome (SIRS) form. The data were analysed using
binary logistic regression, with the level of signifcance set at .05.
Results: The majority of the participants were male (68.7%) aged averagely 46.95 years (SD = 19.59%), with those aged 18 to 40 forming the largest group (42.2%). Comorbidity and substance use were found in 36.7% and 57.1% of the participants, respectively. The most common comorbid condition was hypertension (18.4%), whilst the most commonly used substance was alcohol (47.6%). Most of the participants (79.6%) displayed mild degrees of MEWS. SIRS was detected in more than half (55.1%) of the participants, with mild SIRS being most common (42.9%). Based on the analysis, the factors of age, substance use, and MEWS were capable of signifcantly predicting incidence of SIRS in 31% of the trauma patients (Nagelkerke R2 = .31, p < .05), whereas the factor of comorbidity was not.
Recommendations: Nurses should perform SIRS evaluation on middle-aged and older patients, patients with a history of substance use, and patients with a moderate to severe degrees of MEWS, in the emergency department. This could quicken SIRS detection, reduce complications, and determine proper treatment processes for each patient.
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