Risk Factors Associated with Mortality in Severe Chest Trauma Patients Admitted to the ICU.
Jesús Abelardo Barea-MendozaMario Chico-FernándezQuintana Díaz ManuelJon Pérez-BárcenaLluís Servia-GoixartIsmael Molina-DíazMaría Bringas-BolladaAntonio Luis Ruiz-AguilarMaría Ángeles BallesterosJuan Antonio Llompart-Pounull On Behalf Of The Neurointensive Care And Trauma Working Group Of The Sociedad Española de Medicina Intensiva Crítica Y Unidades Coronarias SemicyucPublished in: Journal of clinical medicine (2022)
Our objective was to determine outcomes of severe chest trauma admitted to the ICU and the risk factors associated with mortality. An observational, prospective, and multicenter registry of trauma patients admitted to the participating ICUs (March 2015-December 2019) was utilized to collect the patient data that were analyzed. Severe chest trauma was defined as an Abbreviated Injury Scale (AIS) value of ≥3 in the thoracic area. Logistic regression analysis was used to evaluate the contribution of severe chest trauma to crude and adjusted ORs for mortality and to analyze the risk factors associated with mortality. Overall, 3821 patients (39%) presented severe chest trauma. The sample's characteristics were as follows: a mean age of 49.88 (19.21) years, male (77.6%), blunt trauma (93.9%), a mean ISS of 19.9 (11.6). Crude and adjusted (for age and ISS) ORs for mortality in severe chest trauma were 0.78 (0.68-0.89) and 0.43 (0.37-0.50) ( p < 0.001), respectively. In-hospital mortality in the severe chest trauma patients without significant traumatic brain injury (TBI) was 5.63% and was 25.71% with associated significant TBI ( p < 0.001). Age, the severity of injury (NISS and AIS-head), hemodynamic instability, prehospital intubation, acute kidney injury, and multiorgan failure were risk factors associated with mortality. The contribution of severe chest injury to the mortality of trauma patients admitted to the ICU was very low. Risk factors associated with mortality were identified.
Keyphrases
- trauma patients
- traumatic brain injury
- cardiovascular events
- early onset
- risk factors
- cardiovascular disease
- end stage renal disease
- newly diagnosed
- cross sectional
- clinical trial
- ejection fraction
- spinal cord injury
- cardiac surgery
- electronic health record
- deep learning
- machine learning
- acute respiratory distress syndrome
- severe traumatic brain injury
- peritoneal dialysis