Mortality analysis of hospitalized trauma patients in the intensive care unit

Mehmet Duran; Öznur Uludag

doi:10.28982/josam.780138

Authors

Mehmet Duran https://orcid.org/0000-0001-7568-3537
Öznur Uludag https://orcid.org/0000-0002-6017-5836

DOI:

https://doi.org/10.28982/josam.780138

Keywords:

Intensive care unit, Mortality, Trauma

Abstract

Aim: Trauma accounts for around five million deaths a year and constitutes a serious threat to public health globally. We examined the characteristics of patients admitted to the intensive care unit (ICU) due to trauma in 2015 and investigated the mortality rate and affecting factors. Methods: In this retrospective cohort study, the data of 101 trauma patients who were followed up at the general ICU in Adıyaman University Training and Research Hospital between January 2015 and December 2015 were analyzed. Patients’ demographic data, regions and causes of trauma, hospitalization durations, Glasgow Coma Scale (GCS) scores, whether blood products were transfused, mechanical ventilation support, operations, and duration of stay in ICU were noted. We then divided the patients into two groups as survivors and non-survivors and examined the mortality rates and the effective factors. Results: Mortality rates of the patients were 15.8%. The mean age of the patients included in the study was 30.73 (25.188) years. Among all, there were 71 males and 30 females. The most common causes of trauma were in-vehicle traffic accidents (33.7%), falls (28.7%) and extravehicular traffic accidents (24.8%). The patients were often admitted to the ICU because of head trauma. The ICU length of stay was significantly higher in the non-survivor group compared to the discharged group (12.81 (23.49) vs. 3.78 (2.84) days, P<0.001), along with the duration of mechanical ventilation (2.49 (8.85) vs. 0.74 (1.30), P<0.001). GCS scores at admission were significantly lower in the non-survivor group (5.88 (3.12) vs. 11.98 (2.70), P<0.001). Conclusion: Direct exposure to trauma as a pedestrian, duration of mechanic ventilation, and low GCS scores during admission increase mortality in patients admitted to the ICU due to trauma.

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References

Jennett B. Epidemiology of head injury. J Neurol Neurosurg Psychiatry. 1996;362–9.

Guven C, Kafadar H. Evaluation of extremity vascular injuries and treatment approaches. Niger J Clin Pract. 2020 Sep;23(9):1221-8. doi: 10.4103/njcp.njcp_656_18. PMID: 32913160.

WHO. Injuries and violence: the facts 2014

Christopher P, Murray JL. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015:10;385(9963):117–71.

Murray CJL, Ortblad KF, Guinovart C, Lim SS, Wolock TM, Roberts DA, et al. Articles Global, regional , and national incidence and mortality for HIV, tuberculosis ,and malaria during 1990 – 2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;6736(14):1–66.

Colburn TN, Meyer DR. Sports Injury or Trauma? Injuries of the competetion off-road motorcyclist. Injury. 2003;34:207-14.

Yan-Hong L, Rahim Y, Wei L, Gui-Xiang S, Yan Y, De Ding Z, et al. Pattern of traffic injuries in Shangai :implications for control. Injury Control and Safety Promotion. 2006;13:217-25.

Morgan GE. Clinical Anesthesiology. 4th ed. McGraw-Hill Medical; 2005

Hefny AF, Idris K, Eid HO, Abu-Zidan FM. Factors affecting mortality of critical care trauma patients. African Health Sciences. 2013;13:731-5.

Dur A, Koçak S, Cander B, Sönmez E, Civelek C. Factors affecting mortality in patients with multitrauma which were treated in intensive care unit. Dicle Medical Journal. 2013;40:177-82.

Banerjee M, Bouillon B, Shafizadeh S, Paffrath T, Lefering R, Wafaisade A, et al. Epidemiology of extremity injuries in multiple trauma patients. Injury. 2013;10:15-21.

Türkiye İstatistik Kurumu, Ölüm Nedeni İstatistikler, 2016 Sayı: 24572 27 Nisan 2017

Podoll AS, Kozar R, Holcomb JB, Finkel KW. Incidence and Outcome of Early Acute Kidney Injury in Critically-Ill Trauma Patients. Plos One. 2013;8:77376

Kara İ, Altınsoy S, Gök U, Onur A, Sarıbapıcçı R. Bir Numune Hastanesi Genel Yoğun Bakım Ünitesinde Travma Hastalarının Mortalite Analizi. Türk Yoğun Bakım Derneği Dergisi. 2015;13:68-74.

Ünlü AR, Ülger F, Dilek A, Barış S, MuratN, Sarıhasan B. Yoğun Bakımda İzlenen Travma Hastalarında “Revize Travma Skoru” ve “Travma ve Yaralanma Şiddeti Skoru’’nun Prognoz ile İlişkisinin Değerlendirilmesi. Türk Anest Rean Der Dergisi. 2012;40:128-35.

Rüden CV, Woltmann A, Röse M, Wurm S, Rüger M, Hierholzer C, et al. Outcome after severe multiple trauma: a retrospective analysis. J Trauma Manag Outcomes 2013;7:4.

Dresing K. Recommended guidelines for diagnostics and therapy in trauma surgery. Eur J Trauma. 2002; 27:137–50.

Barie PS, Hydo LJ, Fischer E. A prospective comparison of two multiple organ dysfunction/failure scoring systems for prediction of mortality in critical surgical illness. J Trauma. 1994;37:660–6.

Rhee P, Joseph B, Pandit V, et al. Increasing trauma deaths in the United States. Ann Surg. 2014;260:13-21.

Akoğlu H, Denizbaşı A, Ünlüer E, Güneysel Ö, Onur Ö. Marmara Üniversitesi Hastanesi Acil Servisine Başvuran Travma Hastalarının Demografik Özellikleri. Marmara Medical Journal. 2005;18;113-22.

Varol O, Eren ŞH, Oğuztürk H, Korkmaz İ, Beydilli İ. Acil servise trafik kazası sonucu başvuran hastaların incelenmesi. CÜ Tıp Fakültesi Derg. 2006;28:55-60.

Guenther S, Waydhas C, Ose C, Nast-Kolb D. Quality of multiple trauma care in 33 German and Swiss trauma centers during a 5-year period: regular versus on-call service. J Trauma. 2003;54:972–8.

Durdu T, Kavalci C, Yilmaz MS, Karakilic ME, Arslan ED, Ceyhan ME. Analysis of Trauma Cases Admitted to the Emergency Department. J Clin Anal Med 2013;

Çırak B, Güven MB, Işık S, Kıymaz N, Demir Ö. Acil servise başvuran travma hastaları ile ilgili epidemiyolojik bir çalışma. Ulusal Travma Derg. 1999;5(3):157-9.

Köksal Ö, Çevik Ş, Akköse Aydın Ş, Özdemir F. Acil servise başvuran travma hastalarında rutin testlerin gerekliliğinin analizi. Ulus Travma Acil Cerrahi Derg. 2012;18(1):23-30.

Ozkayin N, Kaan E, Aktuglu K. The state and importance of motorcycle injuries in progression with trauma etiologies. Medical Science and Discovery. 2016;3:219-24.

Mpe MJ, Mathekga K, Mzileni MO. The outcome of neuro-trauma. A 1 year retrospective study in an intensive care unit. In Critical Care BioMed Central. 2001 March;5(1):1-2.

Kuo SCH, Kuo PJ, Rau CS, Chen YC, Hsieh HY, Hsieh CH. The protective effect of helmet use in motorcycle and bicycle accidents: a propensity score-matched study based on a trauma registry system. BMC Public Health. 2017 Aug 7;17(1):639. doi: 10.1186/s12889-017-4649-1.