Evaluation of Trauma Patients Followed Up and Treated in Intensive Care Unit: The Sample of İstanbul Province Training and Research Hospital

Abstract

Objective:Trauma is an important cause of functional limitation, disability, and mortality. This study investigated the clinical characteristics of trauma patients and the factors affecting mortality in intensive care unit (ICU).Materials and Methods:The data of patients who were followed up due to trauma in the ICU of University of Health Sciences Turkey, İstanbul Kanuni Sultan Süleyman Training and Research Hospital between January 2019-2020 were evaluated retrospectively. Demographic data, comorbidities, trauma etiologies, Glasgow coma score (GCS), Acute Physiology Assessment and Chronic Health Evaluation-II (APACHE-II) score, revised trauma score (RTS), lactate levels, and mortality were investigated.Results:Two hundred fifty (25.2%) patients were followed up in the ICU with a trauma diagnosis. 60.4% of the patients were male, and the median age was 58.5 (1-97). 71.6% of the patients had no systemic disease. While blunt trauma was observed in 94% of the patients, the most common type of trauma was falling, with 64.4%. ICU and mechanical ventilation (MV) stay median lengths were 4 (1-86) and 1 (0-53) days. The median ICU admission GCS was 11 (3-15), APACHE-II score was 22 (5-56), RTS of 7 (2-10) and lactate value was 1.66 (0.7-19.8) mmoL. While 85.6% of the patients were discharged, 14.4% died. Age, duration of stay in ICU and MV, lactate levels, and APACHE-II scores were significantly higher in patients with mortality. GCS and RTS scores were significantly lower (p<0.05). In multiple logistic regression analyses, RTS and lactate values were independent risk factors for mortality.Conclusion:We think that high lactate levels and low RTS help predict mortality in trauma patients in the ICU.

Keywords

• trauma
• intensive care unit
• mortality
• scoring systems
• lactate