Vital sign thresholds predictive of death in the combat setting

Identifying patients at imminent risk of death is a paramount priority in combat casualty care. This study measures the vital sign values predictive mortality among casualties Iraq and Afghanistan. We used data from Department Defense Trauma Registry January 2007 to August 2016. highest documented heart rate lowest systolic pressure emergency department for each casualty. constructed receiver operator curves (ROCs) assess accuracy these variables predicting survival hospital discharge. There were 38,769 encounters which our dataset included 15,540 (40.1%). The median age was 25 years 97.5% male. most common mechanisms injury explosives (n = 9481, 61.0%) followed by gunshot wounds 2393, 15.3%). discharge 97.5%. 94 beats per minute (bpm) with area under ROC 0.631 an optimal threshold predict 110 bpm (sensitivity 52.2%, specificity 79.2%). blood 128 mmHg 0.790 112 68.5%, 81.5%). Casualties <112 mmHg, are high mortality, value significantly higher than traditional 90 threshold. Our highlights need better methods guide resuscitation as measurements have limited mortality.