Emanuel Eguia1, Adrienne N Cobb2, Marshall S Baker3, Cara Joyce4, Emily Gilbert5, Richard Gonzalez2, Majid Afshar6, Matthew M Churpek7. 1. Loyola University Chicago Burn Shock Trauma Research Institute, Maywood, IL, USA; Department of Surgery, Acute Care Surgery Division, Loyola University Chicago, Maywood, IL, USA. Electronic address: emanuel.eguia@lumc.edu. 2. Loyola University Chicago Burn Shock Trauma Research Institute, Maywood, IL, USA; Department of Surgery, Acute Care Surgery Division, Loyola University Chicago, Maywood, IL, USA. 3. Department of Surgery, Acute Care Surgery Division, Loyola University Chicago, Maywood, IL, USA. 4. Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA. 5. Division of Pulmonary and Critical Care Medicine, Loyola University Chicago, Maywood, IL, USA. 6. Loyola University Chicago Burn Shock Trauma Research Institute, Maywood, IL, USA; Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA; Division of Pulmonary and Critical Care Medicine, Loyola University Chicago, Maywood, IL, USA. 7. Division of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL, USA.
Abstract
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 inaccuracy 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.
BACKGROUND: We aim to examine the risk factors associated with infection in traumapatients and the Sepsis-3 definition. METHODS: This was a retrospective cohort study of adult traumapatients admitted to a Level I trauma center between January 2014 and January 2016. RESULTS: A total of 1499 traumapatients met inclusion criteria and 15% (n = 232) had an infection. Only 19.8% (n = 46) of infectedpatients 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 infectedpatients, 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 inaccuracy 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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