In this study, the presence of AKI was found to be an independent risk factor in the development of in-hospital mortality according to all classification systems (RIFLE, AKIN, CK, and KDIGO) in critically traumatic patients followed in ICU, and the compatibility between RIFLE, AKIN, and KDIGO was the highest among the classification systems.

Objective The aim of the present study is to evaluate the frequency, etiology, risk factors and clinical outcomes in acute traumatic SCI patients who develop fever and to evaluate the relationship between fever and mortality. Design Retrospective data were collected between January 2007 and August 2016 from patients diagnosed with persistent fever from SCI cases observed in the ICU. Participants Among 5370 intensive care patients, 435 SCI patients were evaluated for the presence of fever. A total of 52 patients meeting the criteria were evaluated. Outcome measures Fever characteristics were evaluated by dividing the patients into two groups: infectious (group-1) and non-infectious (group-2) fever. Demographic and clinical data, ICU and hospital stay, and mortality were evaluated. Results In the patients with noninfectious fever, mortality was significantly higher compared to the group with infectious fever (P < 0.001). Of 52 acute SCI cases, 25 (48.1%) had neurogenic fever that did not respond to treatment in intensive care follow-up, and 22 (88%) of these patients died. Maximal fever was 39.10 ± 0.64 °C in Group-1 and 40.22 ± 1.10 ° C in Group-2 (P = 0.001). There was a significant difference in the duration of ICU stay and hospital stay between the two groups (P = 0.005, P = 0.001, respectively), while there was no difference in the duration of mechanical ventilation between the groups (P = 0.544). Conclusion This study demonstrates that patients diagnosed with neurogenic fever following SCI had higher average body temperature and higher rates of mortality compared to patients diagnosed with infectious fever.

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Our purpose was to determine whether non-closure of the visceral peritoneum alters post-operative outcome at abdominal hysterectomy. A prospective, randomized trial was performed. Of the 100 evaluable subjects, 50 had the visceral peritoneum left open whereas 50 were closed. Patients were observed for evidence of morbidity after the operation. Analysis of data was performed with use of the unpaired t-test for continuous variables. The visceral peritonization process at abdominal hysterectomy does not provide immediate post-operative benefits while unnecessarily lengthening surgical time and anesthesia exposure. We suggest that visceral peritonization process can be abolished at abdominal hysterectomy.

BACKGROUND:Multiple traumas are a leading cause of mortality among young adults worldwide. Thoracic trauma causes approximately 25% of all trauma-associated deaths. This study aims to determine the independent prognostic factors of mortality in cases with thoracic trauma (isolated or with accompanying organ injuries) who were admitted to the intensive care unit (ICU). METHODS:We retrospectively reviewed data from patients with thoracic trauma who were admitted to our ICU between 2007 and 2016. After excluding pediatric patients (aged <18 years), the study sample included 564 cases. From the records, we collected the patients' demographical data, comorbid diseases, primary trauma as an indication for ICU admission, other traumas accompanying thoracic trauma, type of thoracic injury, and therapeutic interventions. The study sample was divided into two subsets: survival and non-survival groups. These two groups were compared with regards to first ICU day laboratory results and intensive care scores, mechanical ventilation times, and ICU stay lengths. RESULTS:Of the 8063 patients admitted to the ICU between 2007 and 2016, 616 (7.6%) had thoracic trauma. The median age (min-max) of the 564 patients eligible for this study was 43 (18-87) years. Mortality occurred in 159 (28.1%) cases, while 405 (71.8%) were discharged from the ICU. Multivariate regression analyses were also performed, in which every increment in age was associated with a 1.025-fold increase in the odds of mortality due to thoracic trauma. Additionally, the presence of central nervous system (CNS) trauma was associated with a 2.147-fold increase, and the presence of pulmonary contusion was associated with a 1.752-fold increase. CONCLUSION:Results of this study indicate that advanced age, the presence of pulmonary contusion, and accompanying CNS trauma are independent predictors of mortality in patients with thoracic trauma in the ICU. Our non-invasive approach is further supported by the trauma and injury severity score (TRISS) scoring system, which is one of the latest scoring systems used in trauma cases.