Epidemiology, prognostic factors, and outcome of trauma patients admitted in a Brazilian intensive care unit

Figures & data

Table 1 Demographic, clinical, and outcome data

Variables	Total	Traffic	Violence	Falls	Others
n	144	87	45	10	2
Age, mean±SD	33.3±14.5	31.4± 13.6	30.9± 11.1	53.7±19.2	41.5±7.8
<45	80.6%	81.6%	91.1%	30%	50%
45–70	17.4%	17.2%	8.9%	50%	50%
>70	2.0%	1.1%	0	20%	0
Male gender, %	82.6%	78.2%	91.1%	80%	100%
Admission APACHE II, mean±SD	18.6±7.2	19.5±6.9	17.0±7.9	20.1 ±6.1	16±5.6
ISS, mean±SD	34.6± 13.9	36.2± 15.1	33.3± 11.6	29.0± 11.8	20.5±6.4
BMI, mean±SD	26.2±4.9	27.0±4.8	26.0±4.9	24.0±3.9	26.1 ±26.1
Smoking, %	10.4%	10.3%	13.3%	0	0
Alcoholism, %	14.6%	6.9%	24.4%	30%	50%
Illicit drugs use, %	6.9%	3.4%	14.9%	0	0
Comorbidities, %
COPD	1.4%	2.3%	0	0	0
SH	10.4%	10.3%	4.2%	30%	50%
Others	16.7%	16.1%	14.9%	20%	50%
Complications and outcomes
Complications, %
ARDS	52.1%	56.3%	46.7%	40%	50%
ARF	22.2%	16.1%	26.7%	50%	50%
Dialysis need	11.1%	9.2%	11.1%	30%	0
Infections (ICU-acquired)	77.8%	77.0%	80.8%	60%	50%
Invasive MV length of time, days, mean±SD	9.8± 13.4	11.5± 16.0	7.8±8.2	8.5±4.9	7.5±2.5
0	6.9%	4.6%	13.3%	0	0
1–2	14.6%	11.5%	24.4%	0	0
3–5	23.6%	21.8%	24.4%	30%	50%
6–9	18.8%	21.8%	11.1%	30%	0
10–14	22.2%	23.0%	15.6%	40%	50%
>14	13.9%	17.3%	11.2%	0	0
Lowest PaO2/FiO2, mean±SD	198.6± 108.2	184.3±105.4	182.6± 105.3	218.7±92.9	182.4± 143.7
<100	19.5%	23.0%	15.5%	10%	50%
100–199	42.1%	39.1%	51.1%	40%	0
200–299	24.8%	24.1%	22.2%	30%	50%
>299	13.5%	13.8%	11.1%	20%	0
Highest PEEP, cmH2O, mean±SD	7.7±3.9	8.3±4.4	6.9±2.4	7.2±4.6	7.0± 1.4
<6	33.3%	27.6%	44.4%	50%	0
6–10	52.8%	56.3%	46.7%	40%	100%
11–15	9.0%	10.3%	8.9%	0	0
>15	4.9%	5.8%	0	10%	0
Lowest prehospital GCS, mean±SD	8.9±4.7	7.8±4.2	10.5±5.0	10.0±5.1	7.5
3–8	48.6%	59.8%	28.9%	40%	50%
9–13	26.4%	27.6%	24.4%	20%	50%
>13	25.0%	12.6%	46.7%	40%	0
ICP catheter use, %	14.6%	16.19%	6.7%	30%	0
VAD need, %	66.0%	67.8%	60.0%	70.0%	100%
ICU length of time, days, mean±SD	12.9± 14.3	14.8± 17.0	9.8±8.3	7.3±5.6	7.0±2.8
Hospital length of time, days, mean±SD	22.9± 15.4	25.9±22.6	18.8± 12.9	13.5±16.0	11.5±3.5
ICU mortality, %	22.9%	20.7%	20%	50%	50%
Hospital mortality, %	24.3%	23.0%	20%	50%	50%

Abbreviations: APACHE, Acute Physiology and Chronic Health Evaluation; ISS, Injury Severity Score; BMI, body mass index; SH, systemic hypertension; ARDS, acute respiratory distress syndrome; ARF, acute renal failure; MV, mechanical ventilation; PaO₂, arterial pressure of oxygen; FiO₂, fraction of inspired oxygen; PEEP, positive end-expiratory pressure; ICP, intracranial pressure; VAD, vasoactive drugs; ICU, intensive care unit; GCS, Glasgow Coma Score.

Figure 1 Trauma by violence (n=45) or traffic accidents (n=87): region (site) of the body affected, according to the type of trauma. The total percent of each type of trauma can be higher than 100%.

Table 2 Differences between deaths and survivors among patients with trauma by traffic accidents (n=87) and violence (n=45)

Variables	Total	Alive (Hospital)	Death (Hospital)	P-value
Traffic	n=87	n=67	n=20
Place of accident, %
Town	67.8%	70.1%	60%	0.563
Road (including countryside)	29.9%	26.9%	40%	0.396
Countryside (excluding road)	2.3%	3.0%	0	0.944
Patient’s vehicle, % By foot (no vehicle)	9.2%	8.9%	10%	0.765
Bike	5.7%	4.5%	10%	0.700
Motorcycle	52.9%	55.2%	45%	0.583
Car	31.0%	30.0%	35%	0.872
Truck	1.1%	1.5%	0	0.518
Organs affected by trauma, %
Brain	71.3%	71.6%	70%	0.889
Cervical spine	12.6%	13.4%	10%	0.983
Thorax	36.8%	41.8%	20%	0.131
Abdomen	20.7%	20.9%	20%	0.819
Pelvis	4.6%	3.0%	10%	0.479
APACHE II, mean±SD	19.5±6.9	18.9±6.9	21.6±6.5	0.126
ISS, mean±SD	36.2±15.1	36.0± 15.5	36.9± 13.9	0.817
Male gender, %	78.2%	77.6%	80%	0.935
Age, years, mean±SD	31.4±13.6	29.7±12.8	37.1 ± 15.2	0.032
Lowest GCS, mean±SD	7.5±4.5	7.2±4.5	8.6±4.5	0.229
ARDS, %	56.3%	49.2%	80%	0.030
VAD need (any type), %	67.8%	64.2%	80%	0.290
Thrombocytopenia, %	40.2%	34.3%	60%	0.073
ARF, %	16.1%	8.9%	40%	0.003
Dialysis, %	9.2%	4.5%	25%	0.019
ICU length of time (days), mean±SD	14.8±17.0	13.3±8.3	19.7±32.2	0.141
Hospital length of time (days), mean±SD	25.9±22.6	27.0± 19.2	22.1 ±31.8	0.399
Violence	n=45	n=36	n=9
Type of trauma, %
Gunshot	60%	52.8%	88.9%	0.110
Stabbing	15.6%	16.7%	11.1%	0.918
Aggression	24.4%	30.5%	0	0.140
Organs affected by trauma, %
Brain	35.6%	41.7%	11.1%	0.186
Cervical spine	13.3%	13.9%	11.1%	0.742
Thorax	44.4%	41.7%	55.5%	0.708
Abdomen	40%	30.5%	77.7%	0.028
Pelvis	8.9%	11.1%	0	0.694
Upper limbs	17.8%	22.2%	0	0.284
Lower limbs	8.9%	4.4%	22.2%	0.284
APACHE II, mean±SD	17.0±7.9	15.3±7.2	24.1 ±6.8	0.002
ISS, mean±SD	33.3± 11.6	32.9± 12.2	34.8±9.1	0.665
Male gender, %	91.1%	91.7%	88.9%	0.695
Age, years, mean±SD	30.9±11.1	30.9± 12.2	31.1 ±5.0	0.962
Lowest GCS, mean±SD	10.4±4.8	10.5±4.7	9.8±5.6	0.703
ARDS, %	46.7%	41.7%	66.7%	0.331
VAD need (any type), %	60%	55.6%	77.8%	0.403
Thrombocytopenia, %	19.1%	13.1%	44.4%	0.099
ARF, %	25.5%	15.8%	66.7%	0.007
Dialysis, %	10.6%	5.3%	33.3%	0.069
ICU length of time (days), mean±SD	9.8±8.3	9.9±8.0	10.3±9.6	0.898
Hospital length of time (days), mean±SD	18.8±13.0	19.9± 12.9	13.9± 13.3	0.220

Abbreviations: APACHE, Acute Physiology and Chronic Health Evaluation; ISS, Injury Severity Score; GCS, Glasgow Coma Score; ARDS, acute respiratory distress syndrome; ARF, acute renal failure; MV, mechanical ventilation; VAD, vasoactive drugs; ICU, intensive care unit.

Table 3 Parameters obtained through the application of logistic regression to find the factors associated with the death of patients with trauma from traffic accidents (n=87)

Variable	Value	P-value	OR [IC95%]
Intercept	-3.062	0.000
ARDS	1.442	0.040	4.230 [1.071–16.711]
ARF	1.590	0.049	4.904 [1.009–23.838]

Note: In patients with trauma by violence, no independent predictive factors were found.

Abbreviations: IC95%, lower limit of interval with 95% confidence; ARDS, acute respiratory distress syndrome; ARF, acute renal failure.