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Analysis of fluid resuscitation in critically injured patients - A central role of saline solutions


Sprengel, Kai; Simmen, H; Werner, C; Jensen, K O; Keller, C; Wirth, S; Berli, M; Mica, L (2016). Analysis of fluid resuscitation in critically injured patients - A central role of saline solutions. Journal of Acute Medicine, 6(2):29-34.

Abstract

Objective: Multiple injury patients are mostly in the productive age group and are at high risk of dying by exsanguination. In this study, the focus was set on fluid resuscitation, death, and outcome of critically injured patients.
Methods: In total, 2956 patients were included in this sample. The inclusion criteria were age ≥ 16 years and injury severity score ≥ 16. The sample was divided into groups of patients who died within 72 hours of injury and those who survived. Differences between the groups were measured by analysis of variance and Kruskal–Wallis test for parametric data. Independent predictors were analyzed by logistic regression, and the predictive quality was analyzed by receiver operating curves. The given volumina were normalized according the Trauma Score—Injury Severity Score of each patient. All analyses were performed using SPSS.
Results: The binary logistic regression revealed the given amount of saline solutions and colloids within the first 48 hours as independent predictors of survival (p < 0.001, p = 0.003). The receiver operating curves revealed that the area under the curve increased as a function of time, and after 48 hours it was 0.825 for saline solutions and 0.702 for colloids for survival.
Conclusion: Fluid resuscitation does not negatively influence survival; however, the amount of fluids given within the first 24 hours after trauma is an independent predictor of survival with very good predictive quality.

Abstract

Objective: Multiple injury patients are mostly in the productive age group and are at high risk of dying by exsanguination. In this study, the focus was set on fluid resuscitation, death, and outcome of critically injured patients.
Methods: In total, 2956 patients were included in this sample. The inclusion criteria were age ≥ 16 years and injury severity score ≥ 16. The sample was divided into groups of patients who died within 72 hours of injury and those who survived. Differences between the groups were measured by analysis of variance and Kruskal–Wallis test for parametric data. Independent predictors were analyzed by logistic regression, and the predictive quality was analyzed by receiver operating curves. The given volumina were normalized according the Trauma Score—Injury Severity Score of each patient. All analyses were performed using SPSS.
Results: The binary logistic regression revealed the given amount of saline solutions and colloids within the first 48 hours as independent predictors of survival (p < 0.001, p = 0.003). The receiver operating curves revealed that the area under the curve increased as a function of time, and after 48 hours it was 0.825 for saline solutions and 0.702 for colloids for survival.
Conclusion: Fluid resuscitation does not negatively influence survival; however, the amount of fluids given within the first 24 hours after trauma is an independent predictor of survival with very good predictive quality.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:mortality; multiple trauma; resuscitation; saline solutions
Language:English
Date:14 June 2016
Deposited On:06 Feb 2017 13:38
Last Modified:07 Feb 2017 04:08
Publisher:Elsevier
ISSN:2211-5587
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.jacme.2016.05.001

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Licence: Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)

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