Trauma sepsis

Thornhill, R; Strong, Dan; Vasanth, Suresh; Mackenzie, Iain

doi:10.1177/1460408609356828

Cited by 8 publications

(7 citation statements)

References 169 publications

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“…15 Burns are associated with a higher risk of sepsis which is the main cause of morbidity and mortality in the ICU. 16 ISS was significantly higher in those who died. The high ISS in our study indicates severe injury of admitted patients.…”

Section: Date Presented As Median (Range) or Number (%) As Appropriatmentioning

confidence: 89%

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Factors affecting mortality of critical care trauma patients

Hefny¹,

Idris²,

Eid³

et al. 2013

Afr H. Sci.

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Background: Critically-ill trauma patients have a high mortality. Objective: To study the factors affecting the mortality of ICU trauma patients treated at Al-Ain Hospital, United Arab Emirates (UAE). Methods: All trauma patients who were admitted to the ICU were prospectively collected over three years (2003)(2004)(2005)(2006). Univariate and multivariate analysis were used to compare patients who died and who did not. Gender, age, nationality, mechanism of injury, systolic blood pressure and GCS on arrival, the need for ventilation, presence of head or chest injuries, AIS for the chest and head injuries and the ISS were studied. Results: There were 202 patients (181 males). The most common mechanism of injury was road traffic collisions (72.3 %). The overall mortality was 13.9%. A direct logistic regression model has shown that factors that affected mortality were decreased GCS (p < 0.0001), mechanism of injury (p = 0.004) with burns having the highest mortality, increased age (p = 0.004), and increased ISS (p = 0.02). The best GCS that predicted mortality was 5.5 while the best ISS that predicted mortality was 13.5. Conclusion: Road traffic collision is the most common cause of serious trauma in UAE followed by falls. Decreased GCS was the most significant factor that predicted mortality in the ICU trauma patients.

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Section: Date Presented As Median (Range) or Number (%) As Appropriatmentioning

confidence: 89%

“…11,20 Injury to the central nervous system is the leading cause of mortality in trauma patients. 16 More than 60% of our trauma patients who died had head injury. This can be explained by the low compliance of seatbelts in our community which is as low as 11% leading to more head injury.…”

Section: Date Presented As Median (Range) or Number (%) As Appropriatmentioning

confidence: 99%

Factors affecting mortality of critical care trauma patients

Hefny¹,

Idris²,

Eid³

et al. 2013

Afr H. Sci.

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“…In 1536 the army of King Francis I of France fought at the city of Turin against the army of the Holy Roman Emperor Charles V. After the French army recaptured the city in 1537, their surgeon general, Amroise Pare, wrote a passage in which he reported inevitable consequence of nonfatal wound, dreaded by soldiers. We now entitle Amroise Pare to be the father of modern trauma surgery, and the described entity is now termed posttraumatic sepsis [ 41 ].…”

Section: Immune Response In Severe Trauma With or Without Secondarmentioning

confidence: 99%

Immunoinflammatory Response in Critically Ill Patients: Severe Sepsis and/or Trauma

Šurbatović

Veljović

Jevdjić

et al. 2013

Mediators of Inflammation

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Immunoinflammatory response in critically ill patients is very complex. This review explores some of the new elements of immunoinflammatory response in severe sepsis, tumor necrosis factor-alpha in severe acute pancreatitis as a clinical example of immune response in sepsis, immune response in severe trauma with or without secondary sepsis, and genetic aspects of host immuno-inflammatory response to various insults in critically ill patients.

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“…One of these hypotheses points to the increased pro- and anti-inflammatory response in the first hours after major trauma, but does not precisely explain the difference between physiological and pathological immune response to injury [ 4 ]. A key role in the pathological response to major trauma or infection is played by mediators of systemic inflammatory response syndrome (SIRS) and compensatory anti-inflammatory response syndrome (CARS), which are produced in “excess” and can quickly lead to the damage of organs not affected by the trauma, and the patient’s death [ 5 ]. On the other hand, it was found that patients without septic and organ complications, after extensive trauma, can also demonstrate increased production of pro- and anti-inflammatory mediators [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The diagnostic value of early cytokine response in patients after major trauma – preliminary report

Binkowska¹,

Michalak²,

Pilip³

et al. 2018

cejoi

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This study was aimed to give a better understanding of the mechanisms of early immune response to trauma by assessing the concentration of cytokines in peripheral blood. The study group comprised 32 patients admitted to the Emergency Department due to injury. Depending on the magnitude of the Injury Severity Score (ISS) trauma patients were divided into two groups. In group A (ISS ≥ 20), 13 patients had complications, and five died, while in group B (ISS < 20) only three patients had complications (e.g. respiratory failure and infections). Depending on the extent of the injury, significant differences were observed in the concentrations of cytokines in the treatment groups. The highest levels of IL-6 and IL-1Ra in both groups were recorded in the third hour of hospitalisation and were considerably higher in group A compared to the concentration of these cytokines in group B (p = 0.001). In patients with complications, IL-6 and IL-1Ra concentrations were significantly higher compared to those without complications. Spearman’s rho-correlation showed a statistically significant positive correlation between baseline concentrations of IL-6 (r = 0.64, p < 0.001) and IL-1Ra (r = 0.37, p = 0.042) and the values of the ISS. A high diagnostic sensitivity calculated from ROC curves was found for IL-6 concentrations. In summary, our findings suggest that elevated levels of the cytokines tested, determined in the peripheral blood shortly after injury, may be significantly associated with the occurrence of severe complications, which in some patients can lead to death. Monitoring the levels of these cytokines in patients with a high risk of serious complications should be used routinely.

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Trauma sepsis

Cited by 8 publications

References 169 publications

Factors affecting mortality of critical care trauma patients

Factors affecting mortality of critical care trauma patients

Immunoinflammatory Response in Critically Ill Patients: Severe Sepsis and/or Trauma

The diagnostic value of early cytokine response in patients after major trauma – preliminary report

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