Sepsis and lower limb fractures in road traffic accidents

Abstract

Mortality in road traffic accident, even if is slightly decreasing in most countries due to incremental advances in car safety and better prevention programs, is still a significant cause of death. The purpose of this article was to determine whether the lower limb fractures are a determining factor in the development of sepsis and multiorgan failure in road traffic accidents. Material and methods. Retrospective, descriptive study on 82 consecutive cases of clinical expertises and 100 cases of autopsy reports for road traffic accidents. Two parameters, Sev_In and Sev_Tot were build to assess the severity of the septic process. Results. By analyzing the mean value of neutrophil, leucocyte count, and cerebral, cardiac, hepatic, renal and ICD markers for multiorgan failure in the presence of lower limb fractures we could not establish any statistically significant correlations. The evolution os leucocytes leads to a significant inequality of the variance of the Sev_Tot parameter, with both an increase and a decrease in leucoyte count during hospitalization being associated with a significant increased severity compared to a relative unmodified value of this parameter. Conclusion. Lower limb fractures are not a determining factor in neither the development of a septic process as they do not contribute significantly to the mortality in road traffic accidents. Their contribution to severity scores in these circumstances should therefore be limited, and mortality due specifically to lower limb fractures should be regarded as incidental. The development of sepsis in road traffic accidents is independent upon the presence of lower limb fractures, being caused rather by another traumatic lesions produced in the same context.