In-hospital Complications in Trauma Patients According to Injury Severity.

Abstract

In-hospital complications in trauma patients are frequent and associated with increased morbidity and mortality. The aim of this study was to analyze the association between posttraumatic complications and the injured body region, injury and trauma severity, length of stay, and mortality in hospitalized trauma patients. This observational and retrospective study included 147 trauma patients with posttraumatic complications hospitalized in a university hospital located in São Paulo, Brazil. The injury and trauma severity was measured using the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS), respectively. The association between variables was verified applying χ test, Fisher exact text, likelihood ratio, and Mann-Whitney U test, considering significance level of 5%. The most frequent in-hospital complications were infectious, cardiovascular, metabolic, and renal. Patients with head injury AIS score of 3 or more had higher percentage of neurological complications and those with lower extremity injury AIS score of less than 3 had higher percentage of metabolic and renal complications. There was no association between thoracic injury and cardiovascular complications, nor between types of complications and trauma severity (ISS). Patients without cardiovascular complication and those with infections had longer hospital length of stay, and mortality was higher in those with cardiovascular complications. Complication's studies in trauma patients may contribute to identify events related with poor outcome and to implement specific measures for improving quality of trauma care and patient security.