Abstract:

Objectives: Major trauma is one of the main reasons for admission to the intensive care unit (ICU) with the increase in complications and mortality. The aim of this study is to investigate the complications and characteristics of major trauma patients admitted to ICU. Materials and Methods: In this study, we retrospectively analyzed major trauma patients with an “injury severity score” (ISS)>15 who were admitted to ICU between 2015 and 2018. Demographic and clinical data including age, sex, type of injury, rates of complications and 30-day mortality, length of stay (LOS) in ICU and hospital were determined. Acute physiology and chronic health evaluation (APACHE II) score, ISS, trauma revised injury severity score (TRISS), revised trauma score (RTS) and Glasgow coma scale (GCS) score were calculated. Risk factors causing mortality and complications in patients were investigated. Results: Sixty-one patients [19 (31.1%) males and 42 (68.9%) females] aged between 15 and 88 years (mean 42.6±19.2 years) were admitted to our intensive care unit during the study period. Blunt trauma rate (86.8%) was higher than the penetrating injury rate (13.1%). Complications developed in 67.2% of trauma patients, and acute kidney injury (AKI, 45%), pneumonia (34.4%), severe sepsis or septic shock (32.8%) and pulmonary embolism (PE, 9.8%) were detected respectively according to their prevalence. Mortality rates and LOS in ICU and hospital were higher in patients with complications than in those without complications (p<0.05). There were no statistically significant risk factors for the development of complications according to univariate logistic regression analysis (p>0.05). The 30-day mortality rate was 27.8%. Risk factors for mortality were determined as age, APACHE II, RTS, GCS, ISS, TRISS, AKI, PTE by univariate Cox regression analysis and age, RTS, GCS, AKI, PE by multivariate Cox regression analysis (p<0.05). Conclusion: Major trauma is an important cause of mortality due to both itself and complications occurring during ICU treatment. AKI and PE were observed to be complications that increased mortality.

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