Age-related mortality in blunt traumatic hemorrhagic shock: the killers and the life savers

Hwabejire, John O.; Nembhard, Christine E.; Oyetunji, Tolulope A.; Seyoum, Theodros; Abiodun, Mayowa P.; Siram, Suryanarayana M.; Cornwell, Edward E.; Greene, Wendy R.

doi:10.1016/j.jss.2015.04.056

Cited by 11 publications

(9 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…20 , 36 Upon comparing in the same setting, it was observed that elderly patient was a predictor of death after emergency surgery, as that factor increased the rate by 2.8–4.3 times. 30 As for other studies such as those conducted in the USA, 4 , 11 , 27 , 34 the UK, 37 and Brazil, 38 they showed that elderly patient was a factor contributing to cardiac arrest during anesthesia, especially for patients who were more than 80 years of age. However, those studies had differences with regard to some characteristics of the population selected for entry, such as characteristic data, comorbidity disease, and surgery procedure.…”

Section: Discussionmentioning

confidence: 64%

“…As reported in previous studies, 20 , 21 , 26 it has been found that many factors are associated with perioperative cardiac arrest, including age, 20 , 26 underlying diseases, 2 , 4 American Society of Anesthesiologist (ASA) physical status, 2 , 8 , 9 blood loss, 3 the anatomic site of surgery, 20 , 27 and severity of injury (especially blunt trauma with multiple injuries and vascular injuries). 10 , 12 , 21 Warning of such risk factors would be of help to anesthesia providers to plan appropriate anesthetic care and prepare drugs and resuscitating equipment to promptly deal with cardiac arrest and also create a warning sign tool for detecting signs of cardiac arrest in high-risk patients.…”

Section: Introductionmentioning

confidence: 77%

“…20 Studies held in USA found that blunt trauma patients who underwent craniotomy and thoracotomy were at risk of suffering cardiac arrest more than three times. 27 However, this study was conducted in patients with hemorrhagic shock. Data from the Nebraska Medical Center, Omaha, USA, from 1999 to 2009, showed that upper intra-abdominal injury and intrathoracic injury increased the risk of cardiac arrest by two- to fourfold.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Incidences and factors associated with perioperative cardiac arrest in trauma patients receiving anesthesia

Siriphuwanun

Punjasawadwong

Saengyo

2018

RMHP

View full text Add to dashboard Cite

PurposeThe aim of this study was to determine the incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery.Patients and methodsThis retrospective cohort study was approved by the medical ethical committee, Faculty of Medicine, Maharaj Nakorn Chiang Mai Hospital, Thailand. Data of 19,683 trauma patients who received anesthesia between January 2007 and December 2016, such as patient characteristics, surgery procedures, anesthesia information, anesthetic drugs, and cardiac arrest outcomes, were analyzed. Data of patients receiving local anesthesia by surgeons or monitoring anesthesia care (MAC) and those with much information missing were excluded. Factors associated with perioperative cardiac arrest were identified using univariate analysis and the multiple regression model. A stepwise algorithm was chosen at a P-value of <0.20 which was selected for multivariate analysis. A P-value of <0.05 was concluded as statistically significant.ResultsThe perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were as follows: age >65 years (risk ratio [RR] =1.41, CI =1.02–1.96, P=0.039), American Society of Anesthesiologist (ASA) physical status 3 or higher (ASA physical status 3–4, RR =4.19, CI =2.09–8.38, P<0.001; ASA physical status 5–6, RR =21.58, CI =10.36–44.94, P<0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each P<0.001), cardiopulmonary comorbidities (RR =1.55, CI =1.10–2.17, P=0.012), hemodynamic instability with shock prior to receiving anesthesia (RR =1.60, CI =1.21–2.11, P<0.001), and having a history of alcoholism (RR =5.27, CI =4.09–6.79, P<0.001).ConclusionThe incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with patient’s factors, especially old age and cardiopulmonary comorbidities, a history of drinking alcohol, increased ASA physical status, hemodynamic instability with shock prior to surgery, and sites of surgery such as brain, thorax, abdomen, and the major vascular region. Anesthesiologists and surgeons should be aware of a warning system and a well-equipped track to manage the surgical trauma patients.

show abstract

Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Incidences and factors associated with perioperative cardiac arrest in trauma patients receiving anesthesia

Siriphuwanun

Punjasawadwong

Saengyo

2018

RMHP

View full text Add to dashboard Cite

show abstract

“…[ 6 – 8 ] Interestingly, the majority of trauma patients are young. [ 9 ] In blunt hemorrhagic shock, mortality was associated with increasing age. Multiple organ failure and cardiac arrest were the leading causes of death.…”

Section: Introductionmentioning

confidence: 99%

“…Multiple organ failure and cardiac arrest were the leading causes of death. [ 9 ] In most cases, the trauma patients do not exhibit comorbidities. [ 9 , 10 ] Then, they can serve as controls for assessing the role of age and comorbidities, as compared with those with other causes of admission.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for death in septic shock

Medam¹,

Zieleskiewicz²,

Duclos³

et al. 2017

Medicine

View full text Add to dashboard Cite

The aim of this study was to compare septic shock directly associated-mortality between severe trauma patients and nontrauma patients to assess the role of comorbidities and age. We conducted a retrospective study in an intensive care unit (ICU) (15 beds) of a university hospital (928 beds). From January 2009 to May 2015, we reviewed 2 anonymized databases including severe trauma patients and nontrauma patients. We selected the patients with a septic shock episode. Among 385 patients (318 nontrauma patients and 67 severe trauma patients), the ICU death rate was 43%. Septic shock was directly responsible for death among 35% of our cohort, representing 123 (39%) nontrauma patients and 10 (15%) trauma patients (P < 0.0). A sequential organ failure assessment score above 12 (odds ratio [OR]: 6.8; 95% confident interval (CI) [1.3–37], P = 0.025) was independently associated with septic shock associated-mortality, whereas severe trauma was a protective factor (OR: 0.26; 95% CI [0.08–0.78], P = 0.01). From these independent risk factors, we determined the probability of septic shock associated-mortality. The receiver-operating characteristics curve has an area under the curve at 0.76 with sensitivity of 55% and specificity of 86%. Trauma appears as a protective factor, whereas the severity of organ failure has a major role in the mortality of septic shock. However, because of the study's design, unmeasured confounding factors should be taken into account in our findings.

show abstract

Effects of major trauma care organisation on mortality in a European level 1 trauma centre: A retrospective analysis of 2016-2023

Verdonck,

Peters,

Stroobants

et al. 2024

Injury

View full text Add to dashboard Cite

Age-related mortality in blunt traumatic hemorrhagic shock: the killers and the life savers

Cited by 11 publications

References 12 publications

Incidences and factors associated with perioperative cardiac arrest in trauma patients receiving anesthesia

Incidences and factors associated with perioperative cardiac arrest in trauma patients receiving anesthesia

Risk factors for death in septic shock

Effects of major trauma care organisation on mortality in a European level 1 trauma centre: A retrospective analysis of 2016-2023

Contact Info

Product

Resources

About