Profile, outcome and predictors of mortality of abdomino-pelvic trauma patients in a tertiary intensive care unit in Saudi Arabia

Haddad, Samir H.; Yousef, Zeyad; Al-Azzam, Saleh; Al‐Dawood, Abdulaziz; Al-Zahrani, Ali A.; Alzamel, Heythem; Tamim, Hani; Deeb, Ahmad M.; Arabi, Yaseen M.

doi:10.1016/j.injury.2014.07.025

Cited by 14 publications

(28 citation statements)

References 36 publications

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“…Amerika Birleşik Devletleri'nde (ABD) travma, yaştan bağımsız beşinci ölüm nedenidir ve 1-44 yaş arası ölümlerin ilk nedeni olarak bulunmuştur. 2011 yılında Dünya Sağlık Örgütü, trafik kazalarına bağlı travmanın sonucu olarak yaklaşık 1,3 milyon insanın öldüğünü ve her yıl 50 milyondan fazla insanın yaralandığını bildirmiştir (4).…”

Section: Introductionunclassified

Retrospective Analysis of Trauma Patients Who were Treated and Followed in Anesthesia Intensive Care Unit

Adıyaman¹,

Tokur²,

Bal³

et al. 2019

tybd

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ÖZ Amaç: Yoğun bakım üniteleri (YBÜ), potansiyel olarak yaşamı tehdit eden hastalıklarla uğraşan multidisipliner yapılardır. YBÜ'de tedavi edilen hastaların bir kısmını travma hastaları oluşturmaktadır. Çalışmada YBÜ'de tedavi ve takip ettiğimiz travma hastalarındaki mortalite ve morbidite nedenlerini irdelemeyi amaçladık. Gereç ve Yöntem: Ocak 2014-2016 tarihleri arasında anestezi YBÜ'de yatan travma tanılı hastaların verileri retrospektif olarak değerlendirilmiştir. Hastaların yaş, cinsiyet, eşlik eden hastalık, travma etiyolojisi, klinik tanıları, APACHE-2 ve revize edilmiş travma skoru (RTS), yaralanma şiddeti skorları, mekanik ventilasyonda ve YBÜ'de kalış süreleri, hastanede kalış süreleri, mortalite oranları, yoğun bakımdan çıkış şekilleri ve çıkış Glasgow Koma Skalası skorları, izlem süresince hemodiyaliz gereksinimleri, yoğun bakıma kabulden sonraki ilk 48 saat içinde enteral beslenme durumu ve yoğun bakıma girişteki laktat düzeyleri değerlendirildi. Bulgular: YBÜ'de belirtilen süre içinde toplam 954 hastanın tedavisi yapılmış olup travma tanısıyla toplam 106 hasta (%11,1) takip edilmiştir. Yirmi sekiz ve 90 günlük mortalitelere bakıldığında kaybedilen hastalarda giriş laktat düzeyleri, mekanik ventilatörde kalma süreleri ve APACHE-2 skorları yaşayan hastalarınkine göre anlamlı düzeyde daha fazla bulundu (p<0,05). Yirmi sekiz ve 90 günlük mortaliteler ele alındığında yaşayan hastaların RTS kaybedilen hastalara göre anlamlı daha yüksek bulundu (p<0,01). Kaybedilen hastalar yaşayanlara göre daha yaşlı iken, bu fark sadece 90 günlük mortalitede anlamlıydı (p=0,03). Hastaların ilk 48 saat içinde erken enteral beslenme başlananlarda, laktat ≤2 olan hastalarda, APACHE-2 skoru 20 ve altı olan hastalarda hem 28 günlük mortalite hem 90 günlük mortalite istatistiksel olarak anlamlı daha düşük bulundu. Sonuç: Travma hastalarının yoğun bakıma kabulü sırasında yüksek laktat, APACHE-2 ve düşük RTS düzeyi mortaliteyi arttırmaktadır. Mortalitenin düşürülmesi açısından mekanik ventilasyonda kalış süresinin mümkün olduğunca kısaltılması hedeflenmelidir. Anahtar Kelimeler: Travma, yoğun bakım, YBÜ mortalite ABSTRACT Objective: Intensive care units (ICU) are multidisciplinary structures dealing with potentially life-threatening diseases. Trauma patients are among some of the patients treated in ICU. In this study, we aimed to investigate the causes of mortality and morbidity in trauma patients treated in our ICU. Materials and Methods: The data of trauma patients hospitalized in anesthesia ICU between January 2014-2016 were evaluated retrospectively. Patients' age, gender, concomitant disease, trauma etiology, clinical diagnoses, APACHE-2 revised trauma score (RTS) and injury severity scores, duration of stay in ICU, duration of mechanical ventilation, duration of hospital stay, mortality rates, discharge status from ICU and discharge Glasgow Coma Scale score, hemodialysis requirement during follow-up, enteral nutrition status within 48 hours after admission to ICU and lactate levels at admission to ICU were evaluated. Resu...

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Section: Introductionunclassified

Retrospective Analysis of Trauma Patients Who were Treated and Followed in Anesthesia Intensive Care Unit

Adıyaman¹,

Tokur²,

Bal³

et al. 2019

tybd

View full text Add to dashboard Cite

show abstract

“…They are responsible for important mortality, which makes them a public health problem (Ndiaye et al 2009;Tournier et al 2014). Few series in the literature have attempted to describe the epidemiology of APIs, particularly related to RTAs (Cheynel et al 2011;Haddad et al 2015;Helmi et al 2001).…”

Section: Introductionmentioning

confidence: 99%

Abdominopelvic injuries due to road traffic accidents: Characteristics in a registry of 162,695 victims

Monchal

Ndiaye

Gadegbeku

et al. 2018

Traffic Injury Prevention

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“…There is no agreement of opinions as to which approach is more relevant for trauma outcome prediction. Certain types of injuries are also independent predictors of fatal polytrauma outcome: compound fracture of pelvic bones [31], spine and spinal cord injury in combined TBI [32], bilateral pulmonary contusion and rib fracture in combined chest injury [33], severe TBI or severe chest injury in combined pelvic trauma [34][35][36].…”

Section: Injury Severity Evaluationmentioning

confidence: 99%

“…Coagulopathy and acidosis are associated with the level of blood lactate which also correlates with the severity of multisystem failure and mortality in polytrauma [34,39,66]. Some authors consider the level of blood lactate higher than 2 mmol/L relevant for prognosis [67], others find this value higher than 4.1 mmol/L to be predictive [49].…”

Section: Evaluating the Severity Of Functional Disordersmentioning

confidence: 99%

“…The age of the injured has a certain relationship with the presence of comorbidities as it correlates positively with hospital mortality index in polytrauma and is considered to be an independent predictor of unfavorable outcome by a number of studies [33,34,83]. According to some data, the threshold age when mortality among the injured starts to increase significantly is 55 years [13] or 60 years (mortality 41%) [42,84], other findings state the age of 65 years (mortality 31-50%) [36,85,86] or 75 years (mortality 57%) [57].…”

Section: Evaluating the Severity Of Functional Disordersmentioning

confidence: 99%

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Assessment of Severity and Prognosis of Polytrauma Outcome: the Current State of the Problem (Review)

Seliverstov¹,

Shapkin²

2017

Sovrem Tehnol Med

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The review deals with modern methods of assessing the severity and predicting the outcome of polytrauma. To solve the problem of objective evaluation of polytrauma severity, numerous studies are devoted to the search for independent predictors of its outcome, many of which are included in various scales and statistical models to quantitatively rank the severity of injury in the established intervals and calculate the survival probability. It is generally accepted to take into account the anatomical criteria to determine the severity of damage, and physiological parameters that characterize the response of the body functional systems to the damage. Age, sex, comorbidities, various clinical parameters, indices of acidosis, coagulopathy, oxidative stress, inflammatory response, timely diagnosing and the quality of treatment, the need of rendering various types of emergency aid are considered as independent risk factors of fatal polytrauma outcome.The predictive value and comparative effectiveness used in polytrauma scales assessing the severity of injuries (ISS, NISS, APS, ICISS, TMPM) and functional disorders (GCS, RTS, APACHE II, MODS II, SOFA, SAPS II, MPM II) as well as a variety of combined clinical and anatomical evaluation systems (TRISS, ASCOT, RISC II, PTS, etc.) are being actively discussed in the modern literature. Creating a universal scale is complicated by a variety of damages and disorders caused by a polytrauma, and insufficient study of injury outcome predictors. The proposed survival rates and prognostic factors are tied to specific polytrauma databases differing in terms of mortality and quality of medical care, which is reflected in their predictive value.A clear definition of polytrauma and formation of a unified system of assessing its severity would allow physicians to standardize treatment policy, objectively solve the problems of organization and financial support of medical help to seriously injured people.Key words: polytrauma; prognostic factors in polytrauma; mortality in polytrauma; scales and systems of injury severity evaluation.For contacts: Pavel A. Seliverstov,

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Profile, outcome and predictors of mortality of abdomino-pelvic trauma patients in a tertiary intensive care unit in Saudi Arabia

Cited by 14 publications

References 36 publications

Retrospective Analysis of Trauma Patients Who were Treated and Followed in Anesthesia Intensive Care Unit

Retrospective Analysis of Trauma Patients Who were Treated and Followed in Anesthesia Intensive Care Unit

Abdominopelvic injuries due to road traffic accidents: Characteristics in a registry of 162,695 victims

Assessment of Severity and Prognosis of Polytrauma Outcome: the Current State of the Problem (Review)

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