Prediction of sepsis in trauma patients

He, Jin; Liu, Zheng; Xiao, Yue; Xia, Fan; Yan, Jun; Liang, Huaping

doi:10.4103/2321-3868.135479

Cited by 33 publications

(19 citation statements)

References 86 publications

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“…8 At the same time, trauma patients are at higher risk of ARDS and multi-organ failure due to pro-inflammatory responses after their injury and the anti-inflammatory response against this pro-inflammatory condition aggravates the ARDS and multi-organ failure. 9 …”

Section: Discussionmentioning

confidence: 99%

Challenges of diagnosis of COVID-19 in trauma patients: A case series

Sabetian

Feiz

Shakibafard

et al. 2020

Trauma

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Background Diagnosis of COVID-19 can be challenging in trauma patients, especially those with chest trauma and lung contusion. Methods We present a case series of patients from February and March 2020 who were admitted to our trauma center at Rajaee Hospital Trauma Center, in Shiraz, Iran and had positive SARS-CoV-2 PCR test or chest CT scan suggestive of COVID-19 and were admitted to the specific ICU for COVID-19. Results Eight COVID-19 patients (6 male) with mean age of 40 (SD = 16.3) years old, were presented. All patients were cases of trauma injuries, with multiple injuries including chest trauma and lung contusion, admitted to our trauma center for management of their injuries, but they were diagnosed with COVID-19 as well. Two of them had coinfection of influenza type-B and SARS-CoV-2. All patients were treated for COVID-19 and three of them died; the rest were discharged from hospital. Conclusion Since PCR for SARS-CoV-2 is not always sensitive enough to confirm the cause of pneumonia, chest CT manifestations can be helpful, though, they are not always differentiable from lung contusion. Therefore, both the CT scan and the clinical and paraclinical presentation and course of improvement can be beneficial in diagnosing COVID-19 in the trauma setting.

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Section: Discussionmentioning

confidence: 99%

Challenges of diagnosis of COVID-19 in trauma patients: A case series

Sabetian

Feiz

Shakibafard

et al. 2020

Trauma

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“…Until now, it has not been possible to recognize patients who will develop these relatively late complications in an early phase after trauma. Generally used biomarkers such as leukocyte counts and C-reactive protein (CRP) become positive during infections and therefore have limited prognostic value [7]. Since neutrophils are the first responders to both tissue damage and invading pathogens [8,9], multiple studies focused on neutrophils as potential biomarkers [10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

New automated analysis to monitor neutrophil function point-of-care in the intensive care unit after trauma

Hesselink

Spijkerman

Fraiture

et al. 2020

ICMx

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Background: Patients often develop infectious complications after severe trauma. No biomarkers exist that enable early identification of patients who are at risk. Neutrophils are important immune cells that combat these infections by phagocytosis and killing of pathogens. Analysis of neutrophil function used to be laborious and was therefore not applicable in routine diagnostics. Hence, we developed a quick and pointof-care method to assess a critical part of neutrophil function, neutrophil phagosomal acidification. The aim of this study was to investigate whether this method was able to analyze neutrophil functionality in severely injured patients and whether a relation with the development of infectious complications was present. Results: Fifteen severely injured patients (median ISS of 33) were included, of whom 6 developed an infection between day 4 and day 9 after trauma. The injury severity score did not significantly differ between patients who developed an infection and patients who did not (p = 0.529). Patients who developed an infection showed increased acidification immediately after trauma (p = 0.006) and after 3 days (p = 0.026) and a decrease in the days thereafter to levels in the lower normal range. In contrast, patients who did not develop infectious complications showed high-normal acidification within the first days and increased tasset to identify patients at risk for infections after trauma and to monitor the inflammatory state of these trauma patients. Conclusion: Neutrophil function can be measured in the ICU setting by rapid point-of-care analysis of phagosomal acidification. This analysis differed between trauma patients who developed infectious complications and trauma patients who did not. Therefore, this assay might prove a valuable asset to identify patients at risk for infections after trauma and to monitor the inflammatory state of these trauma patients.

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“…Sepsis is one of the leading causes of in-hospital death. 1,2 Trauma patients with hospital-acquired infections carry higher mortality, cost, and length of stay. 3 Nearly a quarter of trauma patient admissions develop sepsis during their hospital admission.…”

Section: Introductionmentioning

confidence: 99%

“…3 Nearly a quarter of trauma patient admissions develop sepsis during their hospital admission. 1 Approximately 14% of penetrating trauma patients develop sepsis. 4 The mortality rate of those with sepsis is about 13% which increases to 64% in those with septic shock.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for infection and evaluation of Sepsis-3 in patients with trauma

Eguia

Cobb

Baker

et al. 2019

The American Journal of Surgery

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Background: We aim to examine the risk factors associated with infection in trauma patients and the Sepsis-3 definition. Methods: This was a retrospective cohort study of adult trauma patients admitted to a Level I trauma center between January 2014 and January 2016. Results: A total of 1499 trauma patients met inclusion criteria and 15% (n = 232) had an infection. Only 19.8% (n = 46) of infected patients met criteria for Sepsis-3, with the majority (43%) of infected cases having a Sequential Organ Failure Assessment (SOFA) score greater on admission compared to the time of suspected infection. In-hospital death was 7% vs 9% (p = 0.65) between Sepsis-3 and infected patients, respectively. Risk factors associated with infection were female sex, admission SOFA score, Elixhauser score, and severe injury (P < 0.05). Conclusion: Patients with trauma often arrive with organ dysfunction, which adds complexity and in-accuracy to the operational definition of Sepsis-3 using changes in SOFA scores. Injury severity score, comorbidities, SOFA score, and sex are risk factors associated with developing an infection after trauma.

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Prediction of sepsis in trauma patients

Cited by 33 publications

References 86 publications

Challenges of diagnosis of COVID-19 in trauma patients: A case series

Challenges of diagnosis of COVID-19 in trauma patients: A case series

New automated analysis to monitor neutrophil function point-of-care in the intensive care unit after trauma

Risk factors for infection and evaluation of Sepsis-3 in patients with trauma

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