Complications and in-hospital mortality in trauma patients treated in intensive care units in the United States, 2013.

Meghan Prin,Guohua Li

doi:10.1186/s40621-016-0084-5

Abstract

BackgroundTraumatic injury is a leading cause of morbidity and mortality worldwide, but epidemiologic data about trauma patients who require intensive care unit (ICU) admission are scant. This study aimed to describe the annual incidence of ICU admission for adult trauma patients, including an assessment of risk factors for hospital complications and mortality in this population.MethodsThis was a retrospective study of adults hospitalized at Level 1 and Level 2 trauma centers after trauma and recorded in the National Trauma Data Bank in 2013. Multiple logistic regression analyses were performed to determine predictors of hospital complications and hospital mortality for those who required ICU admission.ResultsThere were an estimated total of 1.03 million ICU admissions for trauma at Level 1 and Level 2 trauma centers in the United States in 2013, yielding an annual incidence of 3.3 per 1000 population. The annual incidence was highest in men (4.6 versus 1.9 per 100,000 for women), those aged 80 years or older (7.8 versus 3.6–4.3 per 100,000 in other age groups), and residents in the Western US Census region (3.9 versus 2.7 to 3.6 per 100,000 in other regions). The most common complications in patients admitted to the ICU were pneumonia (10.9 %), urinary tract infection (4.7 %), and acute respiratory distress syndrome (4.4 %). Hospital mortality was significantly higher for ICU patients who developed one or more complications (16.9 % versus 10.7 % for those who did not develop any complications, p < 0.001).ConclusionsAdmission to the ICU after traumatic injury is common, and almost a quarter of these patients experience hospital complications. Hospital complications are associated with significantly increased risk of mortality.Electronic supplementary materialThe online version of this article (doi:10.1186/s40621-016-0084-5) contains supplementary material, which is available to authorized users.

Highlights

Traumatic injury is a leading cause of morbidity and mortality worldwide, but epidemiologic data about trauma patients who require intensive care unit (ICU) admission are scant
We summarized the general demographics, clinical scores (e.g., Glasgow Coma Scale, Injury Severity Score) injury types and the presence of hypotension on admission, which has been demonstrated as a prognostic factor in trauma patients (Parks et al 2006)
This study describes the characteristics and outcomes for adult patients admitted to the ICU at Level 1 and Level 2 trauma hospitals after traumatic injury in the United States

Summary

Introduction

Traumatic injury is a leading cause of morbidity and mortality worldwide, but epidemiologic data about trauma patients who require intensive care unit (ICU) admission are scant. This study aimed to describe the annual incidence of ICU admission for adult trauma patients, including an assessment of risk factors for hospital complications and mortality in this population. Pre-hospital systems have been studied extensively to optimize the initial care of trauma patients (Williams et al 2013; McQueen et al 2015; McNeill and Bryden 2013; Ringburg et al 2009; Wilson et al 2015; National Institute for Health and Care Excellence 2016), but there is a shortage of data describing the clinical course of patients admitted to the intensive care unit (ICU) after traumatic injury. The aim of this study was to describe the clinical characteristics of adult patients admitted to the ICU after traumatic injury, including an assessment of the risk factors for hospital complications and hospital mortality in this population.

Objectives

Methods

Results

Discussion

Conclusion