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The Severity of Injury and the Extent of Hemorrhagic Shock Predict the Incidence of Infectious Complications in Trauma Patients


Lustenberger, T; Turina, M; Seifert, Burkhardt; Mica, L; Keel, M (2009). The Severity of Injury and the Extent of Hemorrhagic Shock Predict the Incidence of Infectious Complications in Trauma Patients. European Journal of Trauma and Emergency Surgery, 35(6):538-546.

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).
Conclusions: 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.

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).
Conclusions: 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.

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7 citations in Web of Science®
7 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
04 Faculty of Medicine > University Hospital Zurich > Clinic for Trauma Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:December 2009
Deposited On:18 Mar 2010 12:31
Last Modified:05 Apr 2016 14:03
Publisher:Springer
ISSN:1863-9933
Publisher DOI:https://doi.org/10.1007/s00068-009-8128-y
Related URLs:https://www.zora.uzh.ch/32280/

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