Table 3.
Predictive value of REACT-2 immediate total-body CT criteria for severe injuries, n = 1083
| Backward selection of criteria | |||||||
|---|---|---|---|---|---|---|---|
| Univariate analysis | Original criteria | Adjusted criteria | |||||
| n | OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | |
| Parameters at hospital arrival | |||||||
| Respiratory rate ≥ 30/min or ≤ 10/min | 16 | 1.35 (0.38–4.76) | 0.644 | – | – | – | – |
| Pulse ≥ 120/min | 69 | 1.23 (0.67–2.25) | 0.499 | – | – | – | – |
| Pulse ≥ 130/min* | 49 | 2.29 (0.96–5.43) | 0.061 | – | – | ||
| Pulse ≥ 140/min* | 26 | 2.41 (0.72–8.10) | 0.154 | – | – | ||
| Pulse (continuous)† | 1.02 (1.01–1.02) | < 0.001 | – | – | |||
| Systolic blood pressure ≤ 100 mmHg | 116 | 7.78 (3.14–19.29) | < 0.001 | 5.71 (2.23–14.62) | < 0.001 | 5.72 (2.22–14.75) | < 0.001 |
| Systolic blood pressure < 90 mmHg* | 82 | ∞ (0–∞) | 0.996 | ||||
| Systolic blood pressure < 80 mmHg* | 32 | ∞ (0–∞) | 0.998 | ||||
| Systolic blood pressure (continuous)† | 0.99 (0.98–0.99) | < 0.001 | |||||
| Estimated exterior blood loss ≥ 500 ml | 43 | 3.12 (1.10–8.81) | 0.032 | 3.29 (1.09–9.93) | 0.035 | 3.70 (1.20–11.37) | 0.023 |
| GCS ≤ 13 or abnormal pupillary reaction | 485 | 7.83 (5.32–11.52) | < 0.001 | 10.02 (6.69–15.00) | < 0.001 | 12.65 (8.23–19.45) | < 0.001 |
| GCS ≤ 8* | 437 | 69.24 (25.54–187.66) | < 0.001 | ||||
| GCS = 3* | 394 | 114.45 (28.28–463.28) | < 0.001 | ||||
| GCS (continuous)† | 0.69 (0.64–0.74) | < 0.001 | |||||
| Clinical suspicions | |||||||
| Fractures from at least two long bones | 90 | 2.64 (1.34–5.16) | 0.005 | 4.08 (2.02–8.25) | < 0.001 | 4.94 (2.41–10.15) | < 0.001 |
| Flail chest, open chest, or multiple rib fractures | 114 | 1.62 (0.97–2.71) | 0.066 | 2.81 (1.62–4.86) | < 0.001 | 3.27 (1.85–5.76) | < 0.001 |
| Severe abdominal injury | 65 | 1.39 (0.73–2.65) | 0.313 | – | – | 2.18 (1.07–4.42) | 0.031 |
| Pelvic fracture | 98 | 1.08 (0.66–1.77) | 0.771 | 1.76 (1.03–3.01) | 0.039 | 1.82 (1.05–3.14) | 0.033 |
| Unstable vertebral fractures/spinal cord compression | 69 | 0.64 (0.38–1.09) | 0.098 | – | – | 1.87 (1.06–3.31) | 0.032 |
| Injury mechanisms | |||||||
| Fall from height (> 3 m/> 10 ft) | 319 | 0.35 (0.26–0.47) | < 0.001 | – | – | – | – |
| Fall from height (> 4 m/> 13 ft)* | 166 | 0.70 (0.48–1.01) | 0.054 | 1.64 (1.07–2.52) | 0.022 | ||
| Fall from height (> 5 m/> 16 ft)* | 126 | 0.75 (0.49–1.13) | 0.167 | ||||
| Fall from height (> 6 m/> 20 ft)* | 82 | 1.11 (0.65–1.91) | 0.709 | ||||
| Fall from height (> 7 m/> 23 ft) * | 60 | 2.08 (0.98–4.44) | 0.058 | ||||
| Fall from height (> 8 m/> 26 ft)* | 40 | 2.22 (0.86–5.72) | 0.099 | ||||
| Fall from height (continuous)† | 1.17 (1.06–1.29) | 0.002 | |||||
| Ejection from a vehicle | 30 | 0.45 (0.22–0.95) | 0.037 | – | – | – | – |
| Death of occupant in same vehicle | 17 | 0.56 (0.21–1.53) | 0.261 | – | – | – | – |
| Severely injured patient in same vehicle | 18 | 1.09 (0.35–3.33) | 0.887 | – | – | – | – |
| Wedged or trapped chest/abdomen | 60 | 2.71 (1.04–4.54) | 0.038 | 2.11 (1.00–4.42) | 0.049 | 2.57 (1.20–5.51) | 0.015 |
*Retrospectively adjusted criteria
†Continuous data of regarding criterion used were possible
GCS Glasgow Coma Scale, OR odds ratio, CI confidence interval