Doctors can now identify trauma patients who are at greater risk of death because of a simple blood test taken upon admission.
The Intermountain Medical Center in Salt Lake City completed a study of more than 9,500 patients and discovered that some trauma patients are up to 58 times more likely to die than others, regardless of their original injuries.
These predictions are possible because of a tool called the Intermountain Risk Score.
The Intermountain Risk Score is a computerized tool available to physicians that combines factors like age, gender, and common blood tests known as the complete blood count (CBC) and the basic metabolic profile (BMP) to determine an individual’s mortality risk.
Sarah Majercik, M.D., Intermountain Medical Center surgeon and trauma researcher, says, “It uses components of a very common blood test and almost anybody who comes in the hospital for any reason has these blood tests drawn.”
Majercik says the score prognosticates patients’ pre-injury physiology or pre-injury health state.
“It gives you a higher index of suspicion about a patient who may be of higher risk,” Majercik said. “And it also gives us a concrete number about a patient’s chance of dying. Not your chance of dying immediately but your chance of dying within 30 days or within one year.”
The Intermountain Risk score allowed patients to be categorized into high, moderate- or low-risk levels. They found high-risk men were nearly 58 times more likely to die within a year than low-risk men. High-risk women were 19 times more likely to die within a year than low risk women.
“So that kind of helps us raise our index of suspicion about maybe triaging a patient to a higher level of care,” Majercik said. “It also helps us talk to patients and their families about setting expectations and outcomes.”
Benjamin Horne, Ph.D., director of cardiovascular and genetic epidemiology at the Intermountain Medical Center Heart Institute, began using this tool on patients with cardiology-type illnesses such as heart failure or chronic pulmonary disease and found it to be helpful.
The study says the Intermountain Risk Score will be provide physicians with greater understanding of their trauma patients’ condition and how to more effectively provide treatment for them.
“Some risk factors will be already apparent for physicians, but others aren’t intuitive,” Horne said. “Based on the findings of our research, it’s something that should be looked at as part of the care plan model.”
Patricia Ravet, dean of College of Nursing at BYU, says how health professionals treat patients could change for the better if something like the Intermountain Risk Score is implemented in a way that can be used when trauma patients are admitted.
“As a nurse, I would be more aware of these risks, and what that may then lead to,” Ravet said. “So hopefully, you could catch and prevent a downward spiral most of the time.”
