Red blood cell distribution width and Charlson comorbidity index help to identify frail polytraumatized patients : Experiences from alevelI trauma center.

Abstract

Little is known about the potential impact of the red blood cell distribution width (RDW) and pre-existing comorbidities on the late-phase survival of polytraumatized patients. A total of 173 polytraumatized patients were included retrospectively in this cohort study in alevelI trauma center from January 2012 to December 2015. The Charlson comorbidity index (CCI) scores and RDW values were evaluated. Out of all polytraumatized patients (n = 173), 72.8% (n = 126) were male, the mean ISS was 31.7points (range 17-75) and the mean age was 45.1years (range 18-93years). Significantly higher RDW values (13.90vs. 13.37; p = 0.006) and higher CCI scores (3.38 vs. 0.49; p < 0.001) were seen in elderly polytraumatized patients (age > 55years). RDW values > 13.75% (p = 0.033) and CCI scores > 2points (p = 0.001) were found to have asignificant influence on the late-phase survival of polytraumatized patients. Age > 55years (p = 0.009, HR 0.312; 95% confidence interval (CI) 0.130-0.749) and the presence of severe traumatic brain injury (TBI) (p = 0.007; HR 0.185; 95% CI 0.054-0.635) remained as independent prognostic factors on the late-phase survival after multivariate analysis. Even younger elderly polytraumatized patients (> 55years of age) showed significant higher RDW values and higher CCI scores. In addition to the presence of severe TBI and age > 55years, RDW value > 13.75% on admission and CCI score > 2 might help to identify the "younger" frail polytraumatized patient at risk.