Research Article Potential Risk Factors for In-Hospital Mortality in Patients with Moderate-to-Severe Blunt Multiple Trauma Who Survive Initial Resuscitation Neslihan Yucel , 1 Tuba Ozturk Demir, 1 Serdar Derya, 1 Hakan Oguzturk , 1 Murat Bicakcioglu, 2 and Funda Yetkin 3 1 Department of Emergency Medicine, Inonu University, School of Medicine, Malatya, Turkey 2 Department of Anesthesiology and Reanimation, Inonu University, School of Medicine, Malatya, Turkey 3 Department of Infectious Disease and Clinical Microbiology, Inonu University, School of Medicine, Malatya, Turkey Correspondence should be addressed to Neslihan Yucel; nesyucel@hotmail.com Received 17 September 2018; Accepted 11 November 2018; Published 22 November 2018 Academic Editor: Roberto Cirocchi Copyright © 2018 Neslihan Yucel et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Te aim was to identify risk factors that infuence in-hospital mortality for patients with moderate-to-severe blunt multiple trauma (BMT) who survive initial resuscitation. Methods. Te prospective study involved 195 adult patients with BMT who were admitted to a referral hospital’s emergency department (ED) between May 1, 2015, and May 31, 2016. Results. Forty-three (22%) of the 195 patients died in hospital. Multivariate analysis identifed low blood pH (odds ratio [OR] 6.580, 95% confdence interval [CI] 1.12-38.51), high serum lactate level (OR 1.041, 95% CI 1.01-1.07), high ISS (OR 1.109, 95% CI 1.06-1.16), high APACHE II score (OR 1.189, 95% CI 1.07-1.33), traumatic brain injury (TBI) (OR 4.358, 95% CI 0.76-24.86), severe hemorrhage (OR 5.314, 95% CI 1.07-26.49), and coagulopathy (OR 5.916, 95% CI 1.17-29.90) as useful predictors of acute in-hospital mortality. High ISS (OR 1.047, 95% CI 1.02-1.08), TBI (OR 8.922, 95% CI 2.57-31.00), sepsis (OR 4.956, 95% CI 1.99-12.36), acute respiratory distress syndrome (ARDS) (OR 8.036, 95% CI 1.85-34.84), respiratory failure (OR 9.630, 95% CI 2.64-35.14), renal failure (OR 74.803, 95% CI 11.34-493.43), and multiple organ failure [MOF] (OR 10.415, 95% CI 4.48-24.24) were risk factors for late in-hospital mortality. High Glasgow Coma Scale (GCS) was a good predictor for survival at 2, 7, and 28 or more days of hospitalization (OR 0.708 and 95% CI 0.56-0.09; OR 0.835 and 95% CI 0.73-0.95; OR 0.798 and 95% CI 0.71-0.90, resp.). Conclusion. Several factors signal poor short-term outcome for patients who present to the ED with moderate-to-severe BMT: low blood pH, high serum lactate level, presence of TBI, severe hemorrhage, coagulopathy, organ failure (respiratory, renal, and MOF), and ARDS. For this patient group, ISS and APACHE II scores might be helpful for stratifying by mortality risk, and GCS might be a good predictor for survival. 1. Introduction Despite signifcantly improved trafc safety and occupational safety and despite advances in prehospital and in-hospital management, multiple trauma remains the most frequent cause of death and disabilty worldwide in persons younger than 40 years [1, 2]. Trauma-related death is a subject of great interest in the global literature and can occur in the prehospi- tal period, on admission to the emergency department (ED), or during hospitalization. Te issue of identifying reasons for death afer trauma has been addressed by many researchers and will continue to be investigated until there is a decrease in deaths from potentially preventable and treatable causes [3–5]. Various factors, such as age, severity of injury, site of injury, time to defnitive care, quality of care, and presence of coagulopathy and hemorrhagic shock, are known to afect mortality afer multiple trauma [2, 4, 6]. Mortality and morbididty can be reduced by educating society about frst aid for multiple trauma and by better educating medical staf regarding treatment [7, 8]. Apart from cases of immediate death afer trauma, many predictors of mortality in this patient group are controllable or treatable at the scene, upon admission to the ED, and during hospitalization. Te aim of this study was to identify risk factors that infuence in-hospital mortality for patients with moderate- to-severe blunt multiple trauma (BMT) and that can be Hindawi Emergency Medicine International Volume 2018, Article ID 6461072, 12 pages https://doi.org/10.1155/2018/6461072