Clinical and biostatistical approach to assessing the severity of physical status of patients with combined midface trauma.

Abstract

Objective. The purpose of this study is to search for the main physiological syndrome complexes that characterize the physical status of patients with combined midface trauma, and to study their clinical significance for assessing the severity of patients’ physical status during their hospital stay. Materials and methods. The study was conducted at the Intensive Care Unit No. 2, as well as at the first neurosurgical department (for patients with combined craniofacial trauma and damage to the hearing and vision organs) of the Alexander Hospital in St. Petersburg in the period from 2016 to 2020. The study included 95 patients with combined midface trauma. 22 physiological parameters that fully characterize the severity of patients’ physical status were measured. The measurement was carried out on the first, third, seventh and fourteenth days of patients’ hospital stays. For patients with an unfavorable outcome data were also collected on the last day of their hospital stays in a retrospective manner. A comparative analysis of the physiological parameters in patients with favorable and unfavorable outcomes was performed, based on the dynamics of the principal component. Results. A statistically significant differences were determined in the average values of the coefficients of the first main component (factor) which was formed basing on data collected on the last day of hospital stay for patients with an unfavorable outcome (the main contributions to which were made by the leukocyte index of intoxication, neutrophil-lymphocyte ratio, absolute numbers of lymphocytes and monocytes) among patients with favorable and unfavorable outcomes on the 1st, 3rd, 7th and 14th days after injury. Conclusions. The analysis carried out showed that the variables leukocyte index of intoxication, neutrophil-lymphocyte ratio, absolute numbers of lymphocytes and monocytes can be used to assess the severity of patients’ physical status and best characterize the physical status of patients with unfavorable outcomes at the last day of their hospital stay. The extrapolation of the revealed combinations of variables has the greatest influence on the division of the group of patients with favorable and unfavorable outcomes on the third day after injury.