[Organ failure in patients with multiple trauma. The effect of early osteosynthesis of fractures on complications].
The course of 225 multiple traumatized patients in our ICU with a mean age of 35 +/- 16.8 years, a mean ISS of 30 +/- 8.3 and an overall mortality of 18.2% was evaluated retrospectively. For comparable ISS the mortality was higher in patients over 65 years, and increased further with age. The most common causes of death were MOF (41.5%), severe head injury (34.1%), and acute respiratory failure (ARF) (19.5%). The mortality increased when two or more organ failures were present. 105 patients had fractures of the long bones; in 28 of these all fractures were stabilized primarily (during the first 24 hours). Organ failure was seen less frequently in these patients compared to those with secondary stabilization: ARF 10.7% vs. 51.9% (p less than 0.0004), acute renal failure 3.6% vs. 11.7%, liver failure 3.6% vs. 11.7%, sepsis 14.3% vs. 29.9%. Mortality was significantly lower in the patient with primarily stabilized fractures (7.1% vs. 24.7%, p less than 0.05). The study demonstrates that early stabilization of long bone fractures results in a more favourable course, and that this should be carried out whenever feasible.
Burchardi
H
H
Zentrum für Anästhesiologie, Rettungs- und Intensivmedizin der Universität Göttingen.
Sydow
M
M
Crozier
T A
TA
Burgdorff
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology* / Q000517:prevention & control; D009104:Multiple Trauma / Q000150:complications / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors
Organversagen bei Polytraumapatienten. Einfluss einer frühen Osteosynthese von Frakturen auf Komplikationen.