The intensive care unit admission predicting the factors of late complications in trauma patients: A prospective cohort study

Authors

1 Division of Trauma and Critical Care, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand

2 Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

3 Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand

4 Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

5 Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

6 Department of Anesthesiology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand

7 Department of Anesthesiology, Phramongkutklao Hospital, Bangkok, Thailand

8 Department of Anesthesiology, Navamindradhiraj University, Bangkok, Thailand

9 Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

10 Department of Anesthesiology, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand

Abstract

Background: Organ failure (OF) and sepsis are important causes of late death in trauma. Previous studies reported the methods that could predict OF at the time of patient arrival. However, most of the evidence is from high-income countries, where health-care systems were different from developing countries. This research aimed to identify the factors to predict late complications in trauma patients in surgical intensive care units (SICUs). Methods: This study was a secondary data analysis from the THAI-SICU study, which was a prospective cohort study in nine university-based-SICUs in Thailand. Late complications were defined as any OF or sepsis that occurred after 48 h of ICU admission. Multivariable logistic regression was conducted to identify the significant factors. Results: Three hundred and fourteen patients were eligible for the analysis. Late complications occurred in 60 patients (19%). Patients who had complications had higher Acute Physiology and Chronic Health Enquiry (APACHE II) (15.8 vs. 12.4, p  = 0.02) and Sequential OF Assessment (SOFA) scores on admission (6.7 vs. 3.8, p  < 0.001). Multivariable analysis showed that current smoking (odds ratio [OR] =1.9, 95% confidence interval [CI]; 1.03–3.67, p  = 0.04) and SOFA score on admission (OR = 1.2, 95% CI; 1.12–1.29, p  < 0.001) increased the risk of late complications. Late complications had hazards ratio of mortality of 5.9 (95% CI; 2.53–13.88, p  < 0.001). Conclusions: The incidence of late complications in trauma patients in the SICU was 19%. Current smoking and SOFA score might be valuable in future prediction of late complications during admission.

Keywords

References

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Archives of Trauma Research
Volume 8, Issue 4 - Serial Number 4
October 2019
Pages 203-206

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  • Receive Date: 10 November 2020
  • Accept Date: 10 November 2020

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