Incidence of post-traumatic pneumonia in poly-traumatized patients: identifying the role of traumatic brain injury and chest trauma

Autor: Frank Hildebrand, Philipp Kobbe, Martijn Hofman, Hagen Andruszkow, Martijn Poeze
Přispěvatelé: RS: NUTRIM - R3 - Respiratory & Age-related Health, MUMC+: MA Heelkunde (9), MUMC+: NAZL en ROAZ (9), Surgery
Rok vydání: 2019
Předmět:
Male
ARDS
Poison control
Critical Care and Intensive Care Medicine
0302 clinical medicine
Risk Factors
Brain Injuries
Traumatic
TBI
EPIDEMIOLOGY
Orthopedics and Sports Medicine
Hospital Mortality
infections
polytrauma
risk-factors
Respiratory Distress Syndrome
030222 orthopedics
Abbreviated Injury Scale
Middle Aged
Emergency Medicine
Female
Original Article
Adult
FAILURE ASSESSMENT SCORE
medicine.medical_specialty
Thoracic Injuries
complications
Traumatic brain injury
Multiple Organ Failure
Chest injury
Young Adult
ventilator-associated pneumonia
03 medical and health sciences
Internal medicine
Injury prevention
hospital-acquired pneumonia
medicine
Humans
pneumonia
Mortality
chest injury
Aged
Retrospective Studies
Multiple Trauma
business.industry
030208 emergency & critical care medicine
Poly-trauma
medicine.disease
Respiration
Artificial
Pneumonia
SEVERITY SCORE
Surgery
business
Complication
Zdroj: European Journal of Trauma and Emergency Surgery, 46(1), 11-19. Springer
European Journal of Trauma and Emergency Surgery
ISSN: 1863-9941
1863-9933
DOI: 10.1007/s00068-019-01179-1
Popis: Purpose Traumatic brain injury (TBI) and chest trauma are common injuries in severely injured patients. Both entities are well known to be associated with severe post-traumatic complications, including pneumonia, a common complication with a significant impact on the further clinical course. However, the relevance of TBI, chest trauma and particularly their combination as risk factors for the development of pneumonia and its impact on outcomes are not fully elucidated. Methods A retrospective analysis of poly-traumatized patients treated between 2010 and 2015 at a level I trauma centre was performed. Inclusion criteria were: Injury Severity Score >= 16 and age >= 18 years. TBI and chest trauma were classified according to the Abbreviated Injury Scale. Complications (i.e. acute respiratory distress syndrome (ARDS), multi-organ dysfunction syndrome (MODS) and pneumonia) were documented by a review of the medical records. The primary outcome parameter was in-hospital mortality. Results Over the clinical course, 19.9% of all patients developed pneumonia, and in-hospital mortality was 25.3%. Pneumonia (OR 5.142, p = 0.001) represented the strongest independent predictor of in-hospital mortality, followed by the combination of chest injury and TBI (OR 3.784, p = 0.008) and TBI (OR 3.028, p = 0.010). Chest injury alone, the combination of chest injury and TBI, and duration of ventilation were independent predictors of pneumonia [resp. OR 4.711 (p = 0.004), OR 4.193 (p = 0.004), OR 1.002 (p < 0.001)]. Conclusions Chest trauma alone and especially its combination with TBI represent high-risk injury patterns for the development of pneumonia, which forms the strongest predictor of mortality in poly-traumatized patients.
Databáze: OpenAIRE
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