Decision Trees for Managing Impaired Physical Mobility in Multiple Trauma Patients.
Raisa Camilo Ferreira, Karen Dunn-Lopez, Sue Moorhead and 5 others
PMID 40329698WHAT IT FOUND
In 201 multiple trauma patients, nursing decision trees found that cardiopulmonary monitoring marked higher death risk and good transfer performance marked better mobility.
Mobility interventions were associated with lower mortality, but the study cannot prove they caused it.
Key findings
01Patients monitored for cardiopulmonary status had mortality of 20.8% compared with 10.0% in those not monitored, and patients receiving mobility interventions had mortality of 2.6% compared with 10.0%.
02Patients with good transfer performance scores had 94.9% improved or resolved mobility outcomes, compared with 5.1% with poor scores.
03In 10-fold cross-validation, the mortality decision tree achieved 89.1% accuracy, and the mobility decision tree achieved 93.0% accuracy.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done at one Level 1 trauma centre in a rural area of Brazil, so the patterns may not apply to other hospitals or patient groups. The design was observational, and the model was evaluated by 10-fold cross-validation within the same dataset. The death and worsened mobility outcome groups had small numbers, which affected the statistical tests. The trees were not designed for real-time decision support. Some nursing diagnoses were identified or added by the research team, which may not match routine workflow.
Declared interests
The study was funded by the Brazilian Coordination for the Improvement of Higher Education Personnel (CAPES), and the authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that giving mobility interventions caused lower mortality. The study was observational and the decision trees were tested only by cross-validation within the same dataset, so the 2.6% versus 10.0% mortality difference only describes patterns in these records.