Thomas Lustenberger1, Matthias Turina2,3, Burkhardt Seifert4, Ladislav Mica1, Marius Keel1. 1. Department of Trauma Surgery, University Hospital of Zurich, Zurich, Switzerland. 2. Department of Trauma Surgery, University Hospital of Zurich, Zurich, Switzerland. mturina73@hotmail.com. 3. Department of Trauma Surgery, University Hospital of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland. mturina73@hotmail.com. 4. Biostatistics Unit, Institute for Social and Preventive Medicine, University of Zurich, Zurich, Switzerland.
Abstract
BACKGROUND: Trauma patients are at high risk of developing systemic inflammatory response syndrome (SIRS) and infections. The aim of this study was to evaluate the influence of the severity of injury and the extent of hemorrhagic shock at admission on the incidence of SIRS, infection and septic complications. METHODS: A total of 972 patients who had an injury severity score (ISS) of ≥ 17, survived more than 72 h, and were admitted to a level I trauma center within 24 h after trauma were included in this retrospective analysis. SIRS, sepsis and infection rates were measured in patientswith different severities of injury as assessed by ISS, or with various degrees of hemorrhagic shock according to ATLS(®) guidelines, andwere compared using both uni- and multivariate analysis. RESULTS: Infection rates and septic complications increase significantly (p < 0.001) with higher ISS. Severe hemorrhagic shock on admission is associated with a higher rate of infection (72.8%) and septic complications (43.2%) compared to mild hemorrhagic shock (43.4%, p < 0.001 and 21.7%, p < 0.001, respectively). CONCLUSION: The severity of injury and the severity of hemorrhagic shock are risk factors for infectious and septic complications. Early diagnostic and adequate therapeutic work up with planned early "second look" interventions in such high-risk patients may help to reduce these common posttraumatic complications.
BACKGROUND:Traumapatients are at high risk of developing systemic inflammatory response syndrome (SIRS) and infections. The aim of this study was to evaluate the influence of the severity of injury and the extent of hemorrhagic shock at admission on the incidence of SIRS, infection and septic complications. METHODS: A total of 972 patients who had an injury severity score (ISS) of ≥ 17, survived more than 72 h, and were admitted to a level I trauma center within 24 h after trauma were included in this retrospective analysis. SIRS, sepsis and infection rates were measured in patientswith different severities of injury as assessed by ISS, or with various degrees of hemorrhagic shock according to ATLS(®) guidelines, andwere compared using both uni- and multivariate analysis. RESULTS:Infection rates and septic complications increase significantly (p < 0.001) with higher ISS. Severe hemorrhagic shock on admission is associated with a higher rate of infection (72.8%) and septic complications (43.2%) compared to mild hemorrhagic shock (43.4%, p < 0.001 and 21.7%, p < 0.001, respectively). CONCLUSION: The severity of injury and the severity of hemorrhagic shock are risk factors for infectious and septic complications. Early diagnostic and adequate therapeutic work up with planned early "second look" interventions in such high-risk patients may help to reduce these common posttraumatic complications.
Authors: Paul C Hébert; Dean Fergusson; Morris A Blajchman; George A Wells; Andrew Kmetic; Doug Coyle; Nancy Heddle; Marc Germain; Mindy Goldman; Baldwin Toye; Irwin Schweitzer; Carl vanWalraven; Dana Devine; Graham D Sher Journal: JAMA Date: 2003-04-16 Impact factor: 56.272
Authors: Thomas Lustenberger; Peep Talving; Beat Schnüriger; Barbara M Eberle; Marius J B Keel Journal: World J Surg Date: 2012-01 Impact factor: 3.352
Authors: Krislyn Foster; James Yon; Casey E Pelzl; Kristin Salottolo; Caleb Mentzer; Glenda Quan; Emmett E McGuire; Burt Katubig; David Bar-Or Journal: Trauma Surg Acute Care Open Date: 2021-06-15