ABSTRACT
Objective:
Intensive care units (ICU) are multidisciplinary structures dealing with potentially life-threatening diseases. Trauma patients are among some of the patients treated in ICU. In this study, we aimed to investigate the causes of mortality and morbidity in trauma patients treated in our ICU.
Materials and Methods:
The data of trauma patients hospitalized in anesthesia ICU between January 2014-2016 were evaluated retrospectively. Patients’ age, gender, concomitant disease, trauma etiology, clinical diagnoses, APACHE-2 revised trauma score (RTS) and injury severity scores, duration of stay in ICU, duration of mechanical ventilation, duration of hospital stay, mortality rates, discharge status from ICU and discharge Glasgow Coma Scale score, hemodialysis requirement during follow-up, enteral nutrition status within 48 hours after admission to ICU and lactate levels at admission to ICU were evaluated.
Results:
A total of 954 patients were treated in the ICU and 106 patients (11.1%) were followed up for trauma. Regarding 28-day and 90-day mortality, the mean lactate levels, duration of mechanical ventilation and APACHE-2 scores were significantly higher in non-survivors (p<0.05). When the 28-day and 90-day mortality rates were evaluated, the RTSs of the survivors were found to be significantly higher than non-survivors (p<0.01). While non-survivors were older than the survivors, this difference was only significant in 90-day mortality (p=0.03). Patients with early enteral nutrition within the first 48 hours, lactate levels ≤2 and an APACHE-2 score of 20 and below were found to have a statistically significantly lower 28-day and 90-day mortality rates.
Conclusion:
High lactate, APACHE-2 and low RTS levels increase the mortality rate in trauma patients during admission to ICU. In order to reduce the mortality, the duration of mechanical ventilation should be reduced as much as possible.