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.
Lustenberger, T