A new classification system for evaluating patients with severe trauma using b-type natriuretic peptide levels and estimated glomerular filtration rate

Sunao Morisada, Toyomu Ugawa, Nobuyuki Nosaka, Yoshihito Ujike

Research output: Contribution to journalArticlepeer-review

Abstract

Current systems for the evaluation of trauma severity are tedious and difficult to apply in an actual emergency setting. We aimed to develop and assess the accuracy of a more efficient severity evaluation system, termed the Ugawa classification, using brain-type natriuretic peptide (BNP) measurement and the estimated glomerular filtration rate (eGFR). Two-hundred trauma patients were divided into 2 groups using an eGFR cut-off value of 90ml/min/1.73m2 as an indicator of normal renal function and 2 additional groups according to whether the BNP values were greater or less than the age in years. This resulted in 4 subject groups with different combinations of eGFR and BNP. The mean SOFA score, injury severity scores (ISS), trauma and injury severity scores (TRISS), and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores of the groups were compared by Kruskal- Wallis test, and the mortality rate after 90 days was calculated. Significant intergroup differences were found in SOFA scores, ISS scores, and APACHE Il-predicted mortality rates. Although no significant differences were found in the mortality rate after 90 days or TRISS-predicted mortality rate among the 4 groups, there was a trend toward increasing trauma severity from group 1 to 4. Thus, the Ugawa classification is as accurate as existing systems, has greater efficiency, and is user-friendly.

Original languageEnglish
Pages (from-to)285-290
Number of pages6
JournalActa medica Okayama
Volume68
Issue number5
Publication statusPublished - 2014
Externally publishedYes

Keywords

  • Acute injury
  • Acute physiology and chronic health evaluation II
  • Injury severity score
  • Sequential organ failure assessment
  • Trauma and injury severity score

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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