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Acta Anaesthesiol Scand · Jul 2022
Multicenter StudyChronic critical illness in polytrauma. Results of the Spanish trauma in ICU registry.
- María Ángeles Ballesteros, María Juncal Sánchez-Arguiano, Mario Chico-Fernández, Jesús Abelardo Barea-Mendoza, Luis Serviá-Goixart, Marcelino Sánchez-Casado, Iker García Sáez, Francisca I Pino-Sánchez, Antonio Llompart-PouJuanJServei de Medicina Intensiva, Hospital Universitari Son Espases, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain., Eduardo Miñambres, and Neurointensive Care, Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC).
- Service of Intensive Care, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.
- Acta Anaesthesiol Scand. 2022 Jul 1; 66 (6): 722730722-730.
PurposeChronic critical illness after trauma injury has not been fully evaluated, and there is little evidence in this regard. We aim to describe the prevalence and risk factors of chronic critical illness (CCI) in trauma patients admitted to the intensive care unit.Material And MethodsRetrospective observational multicenter study (Spanish Registry of Trauma in ICU (RETRAUCI)). Period March 2015 to December 2019. Trauma patients admitted to the ICU, who survived the first 48 h, were included. Chronic critical illness (CCI) was considered as the need for mechanical ventilation for a period greater than 14 days and/or placement of a tracheostomy. The main outcomes measures were prevalence and risk factors of CCI after trauma.Results1290/9213 (14%) patients developed CCI. These patients were older (51.2 ± 19.4 vs 49 ± 18.9); p < .01) and predominantly male (79.9%). They presented a higher proportion of infectious complications (81.3% vs 12.7%; p < .01) and multiple organ dysfunction syndrome (MODS) (27.02% vs 5.19%; p < .01). CCI patients required longer stays in the ICU and had higher ICU and overall in-hospital mortality. Age, injury severity score, head injury, infectious complications, and development of MODS were independent predictors of CCI.ConclusionCCI in trauma is a prevalent entity in our series. Early identification could facilitate specific interventions to change the trajectory of this process.© 2022 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
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