Resuscitation with polymeric plasma substitutes is permissive for systemic inflammatory response syndrome and sepsis in multiply injured patients: a retrospective cohort study

Abstract

ObjectiveMultiple trauma is often accompanied by systemic inflammatory response syndrome (SIRS). The aim of this study was to investigate the impact of polymeric plasma substitutes on the development of SIRS or sepsis.MethodsWe included 2969 patients aged ≥16 years with an Injury Severity Score (ISS) >16 in this study. The sample was subdivided into three groups: patients who did not receive colloids and those who received <5L colloids and >5L colloids within the first 48 h. Data were analyzed using IBM SPSS® for Windows version 22.0; analysis of variance was used for continuous normally distributed data and Kruskal–Wallis test for categorical data. The predictive quality of colloid treatment was analyzed using the receiver operating characteristic (ROC) curves. Independent predictively was analyzed by binary logistic regression. Data were considered significant if P < 0.05. Data are presented as the mean ± standard deviation.ResultsThe SIRS score increased with the amount of colloid used (1.9 ± 1.4 vs. 2.4 ± 1.2 vs. 3.2 ± 0.9; P < 0.001). However, the predictive quality was low, with an area under the ROC of 0.693 for SIRS and 0.669 for sepsis (P < 0.001). Binary logistic regression revealed colloids as an independent factor for the development of SIRS and sepsis (odds ratios: SIRS 3.325 and sepsis 8.984; P < 0.001).ConclusionBesides other factors, colloids have a significant permissive effect and are independent predictors for the development of SIRS and sepsis in multiply injured patients. Trial registration ‘Retrospektive Analysen in der Chirurgischen Intensivmedizin’ No. St. V. 01-2008

Development of a Visual Analytics Tool for Polytrauma Patients: Proof of Concept for a New Assessment Tool Using a Multiple Layer Sankey Diagram in a Single‐Center Database

“…Based on the preparative literature review, the factors with the highest impact on outcomes for patients with multiple injuries were reconfirmed from previous reports: ISS, pH, lactate, hemoglobin, hematocrit, temperature and patient age were included in the development (Table 2) [1–20, 30–35, 39–44].…”

“…Use of a dynamic approach appears to be exception to the rule for most studies. In addition, few trauma scoring systems have included physiological parameters [7][8][9]. The data obtained are often utilized to solve research questions by those involved in trauma care, or to assess patient populations [10][11][12].…”

Development of a visual analytics tool for polytrauma patients: Proof of concept for a new assessment tool using a multiple layer sankey diagram in a single-center database

“…Use of a dynamic approach appears to be exception to the rule for most studies. In addition, few trauma scoring systems have included physiological parameters [7][8][9] . The data obtained is often utilized to solve research questions by those involved in trauma care, or to assess patient populations [10][11][12].…”

The initial trauma associated hemorrhagic shock in the multiply injured patient has pro-inflammatory effects. A retrospective single center cohort study

“…There were several trials to determine the origin or the trigger of SIRS during the last decades, though the studies remain descriptive and the initial trigger was not detected [4]. Among the predictors of SIRS, direct indicators such as injury severity (ISS, NISS) and indirect indicators such as the rate of blood transfusions were discussed [5][6][7][8]. Certainly, trauma load, blood loss, and amount of transfused blood go hand in hand and are a result of the trauma.…”