The impact of infection complications after trauma differs according to trauma severity

Komori, Akira; Iriyama, Hiroki; Kainoh, Takako; Aoki, Makoto; Naito, Toshio; Abe, Toshikazu

doi:10.1038/s41598-021-93314-5

Cited by 24 publications

(12 citation statements)

References 25 publications

(40 reference statements)

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“…We also found that older trauma patients experienced longer in-hospital LOS, which is in line with the results reported by other authors [38][39][40] . This could be related to the higher incidence of complications in this population [41][42][43][44] . However, we cannot rule out that these complications may also be the consequence of longer LOS.…”

Section: Discussionmentioning

confidence: 92%

Epidemiology, injury pattern and outcome of older Canadian trauma patients: a 15-year study of a provincial trauma registry

Benhamed

Batomen

Boucher

et al. 2022

Preprint

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IntroductionOlder adults have become a significant portion of the trauma population. The primary objective was to evaluate the temporal changes in the incidence, demographic and trauma characteristics, injury pattern, in-hospital admission, complications, and outcome of older trauma patients. MethodsA multicentre retrospective study was conducted using the Quebec Trauma Registry. Patients aged ≥16 years, admitted to one of the three adult level-I trauma centre between 2003 and 2017 were included. Descriptive analyses were performed.ResultsWe included 53,324 patients and 24,822 were aged ≥65 years. The median age increased from 57[IQR 36-77] to 67[IQR 46-82] years and the proportion of older adults rose from 41.8% to 54.1%. Among those, fall remained the main mechanism (84.7%-88.3%) and the proportion of severe thorax (+8.9%), head (+8.7%), and spine (+5%) injuries increased over time. The proportion of severely injured older patients almost doubled (17.6%-32.3%), yet their mortality decreased (-1%). Their average number of annual bed-days consumption also increased (+15,004 and +1,437 in non-intensive care ward and ICU, respectively).ConclusionsSince 2014, older adults represent the majority of admissions in Level-I trauma centres in Québec. Their bed-days consumption has greatly increased, their injury pattern and severity has deeply evolved, while we showed a decrease in mortality.

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Section: Discussionmentioning

confidence: 92%

Epidemiology, injury pattern and outcome of older Canadian trauma patients: a 15-year study of a provincial trauma registry

Benhamed

Batomen

Boucher

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…We also found that older trauma patients experienced longer in-hospital LOS, which is in line with the results reported by other authors [ 38 – 40 ]. This could be related to the higher incidence of complications in this population [ 41 – 44 ]. However, we cannot rule out that these complications may also be the consequence of longer LOS.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology, injury pattern and outcome of older trauma patients: A 15-year study of level-I trauma centers

et al. 2023

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Background Older adults have become a significant portion of the trauma population. Exploring their specificities is crucial to better meet their specific needs. The primary objective was to evaluate the temporal changes in the incidence, demographic and trauma characteristics, injury pattern, in-hospital admission, complications, and outcome of older trauma patients. Methods A multicenter retrospective cohort study was conducted using the Quebec Trauma Registry. Patients aged ≥16 years admitted to one of the three adult level-I trauma centers between 2003 and 2017 were included. Descriptive analyses and trend-tests were performed to describe temporal changes. Results A total of 53,324 patients were included, and 24,822 were aged ≥65 years. The median [IQR] age increased from 57[36–77] to 67[46–82] years, and the proportion of older adults rose from 41.8% in 2003 to 54.1% in 2017. Among those, falls remain the main mechanism (84.7%-88.3%), and the proportion of severe thorax (+8.9%), head (+8.7%), and spine (+5%) injuries significantly increased over time. The proportion of severely injured older patients almost doubled (17.6%-32.3%), yet their mortality decreased (-1.0%). Their average annual bed-days consumption also increased (+15,004 and +1,437 in non-intensive care wards and ICU, respectively). Conclusions Since 2014, older adults have represented the majority of admissions in Level-I trauma centers in Québec. Their bed-days consumption has greatly increased, and their injury pattern and severity have deeply evolved, while we showed a decrease in mortality.

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“…Afterwards, the patient was transferred to the ICU on October 5, 2021 due to suspected traumatic wet lung infections and persistent low blood oxygen concentration. Greater of injury severity is associated with the higher risk of infections ( 30 ). A previous study of 5,500 patients following trauma revealed that the injury severity score in the infected group was significantly higher compared with that of the non-infected group ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Early detection of gram‑negative bacteria using metagenomic next‑generation sequencing in acute respiratory distress syndrome: A case report

et al. 2022

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Metagenomic next-generation sequencing (mNGS) is an effective method that can be used for the identification of early pathogens in patients with suspected severe pneumonia. However, the potential of mNGS for evaluating the prognosis of acute respiratory distress syndrome (ARDS) in patients with severe pneumonia remains unclear. In the present report, hospital-acquired gram-negative bacteria infections were detected in a case using metagenomic next-generation sequencing (mNGS) in a sample of bronchoalveolar fluid. This was obtained from a 58-year-old male patient with traumatic wet lung after a neurosurgery. According to the results, of which the profiles of the resistance genes were detected by mNGS, drugs designed to control infection were adjusted, namely to polymyxin B (500,000 U/12 h), azithromycin (0.5 g/24 h) and ganciclovir (0.25 g/12 h). Following adjusting treatment for 8 days, the symptoms of lung infection and hypoxemia were markedly improved, resulting in the patient being transferred out of the intensive care unit 15 days after treatment. To conclude, observations from the present report suggest that mNGS is a useful method for the early identification of pathogens in patients with pneumonia caused by ARDS. However, further studies are required to identify the complementary role of mNGS in supporting conventional microbiological methods in routine clinical practice.

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The impact of infection complications after trauma differs according to trauma severity

Cited by 24 publications

References 25 publications

Epidemiology, injury pattern and outcome of older Canadian trauma patients: a 15-year study of a provincial trauma registry

Epidemiology, injury pattern and outcome of older Canadian trauma patients: a 15-year study of a provincial trauma registry

Epidemiology, injury pattern and outcome of older trauma patients: A 15-year study of level-I trauma centers

Early detection of gram‑negative bacteria using metagenomic next‑generation sequencing in acute respiratory distress syndrome: A case report

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