Prognosis-related factors of severe trauma in intensive care unit

Abstract

Objective To evaluate the prognosis-related factors of severe trauma in Intensive Care Unit, and to provide clinical reference for the diagnosis and treatment of severe trauma. Methods The clinical data of all 408 patients with severe trauma and ISS score≥25 admitting to our ICU and from January 2011 to December 2015 were retrospectively analyzed. To summarize the epidemiological characteristics and compare gender, age, site of injury, cause of injury, duration, complications, treatment, ISS score and APACHEⅡscore between the improved group and the death or deterioration group. Results There were 332 people who were improved and 76 people who died or deteriorated. The patients of death and deterioration groups were older, has a higher proportion of self falls, environment disorder, shock, ARF, ARDS and MODS, more complications, and are more likely to accept mechanical ventilation, blood purification, CPR and lower GCS score and higher APACHEⅡ score. The improvement group has more sites of injury higher proportion of chest, limbs and pelvis injury, and is more likely to accept surgical operation and the longer hospital stay. Binary Logistic regression analysis shows that age>55, self falls, MODS, APACHEⅡ>20 and CPR are risk factors of death and deterioration for the severe trauma in ICU. Conclusion It’s essential to pay more attention to the overall situation of patients, preventing complications, and protecting the function of organs during the treatment of severe trauma in ICU. Key words: ICU; Severe trauma; Prognosis; APACHEⅡscore; ISS score; Traumatic complication; Epidemiological characteristics; Regression analysis