Trauma ICU Prevalence Project: the diversity of surgical critical care
| Autor: | Jay Doucet, Samir Fakhry, Niels Martin, Dana Ferrari-Light, Michaela A West, Liz Penaloza, Eric Campion, Christopher Michetti, Vaidehi Agrawal |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
critical care diagnoses medicine.medical_treatment Plenary Paper Critical Care and Intensive Care Medicine ICU mortality 03 medical and health sciences 0302 clinical medicine trauma intensive care unit Intensive care medicine 030212 general & internal medicine Mechanical ventilation Respiratory distress business.industry Septic shock prevalence study 030208 emergency & critical care medicine Patient Acuity Hemothorax medicine.disease Pneumothorax Emergency medicine surgical critical care Surgery business Abdominal surgery |
| Zdroj: | Trauma Surgery & Acute Care Open |
| ISSN: | 2397-5776 |
| DOI: | 10.1136/tsaco-2018-000288 |
| Popis: | BackgroundSurgical critical care is crucial to the care of trauma and surgical patients. This study was designed to provide a contemporary assessment of patient types, injuries, and conditions in intensive care units (ICU) caring for trauma patients.MethodsThis was a multicenter prevalence study of the American Association for the Surgery of Trauma; data were collected on all patients present in participating centers’ trauma ICU (TICU) on November 2, 2017 and April 10, 2018.ResultsForty-nine centers submitted data on 1416 patients. Median age was 58 years (IQR 41–70). Patient types included trauma (n=665, 46.9%), non-trauma surgical (n=536, 37.8%), medical (n=204, 14.4% overall), or unspecified (n=11). Surgical intensivists managed 73.1% of patients. Of ICU-specific diagnoses, 57% were pulmonary related. Multiple high-intensity diagnoses were represented (septic shock, 10.2%; multiple organ failure, 5.58%; adult respiratory distress syndrome, 4.38%). Hemorrhagic shock was seen in 11.6% of trauma patients and 6.55% of all patients. The most common traumatic injuries were rib fractures (41.6%), brain (38.8%), hemothorax/pneumothorax (30.8%), and facial fractures (23.7%). Forty-four percent were on mechanical ventilation, and 17.6% had a tracheostomy. One-third (33%) had an infection, and over half (54.3%) were on antibiotics. Operations were performed in 70.2%, with 23.7% having abdominal surgery. At 30 days, 5.4% were still in the ICU. Median ICU length of stay was 9 days (IQR 4–20). 30-day mortality was 11.2%.ConclusionsPatient acuity in TICUs in the USA is very high, as is the breadth of pathology and the interventions provided. Non-trauma patients constitute a significant proportion of TICU care. Further assessment of the global predictors of outcome is needed to inform the education, research, clinical practice, and staffing of surgical critical care providers.Level of evidenceIV, prospective observational study. |
| Databáze: | OpenAIRE |
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