Early predictors of sepsis in the motor-vehicle crash trauma victim.
BACKGROUND
Sepsis is a major cause of late morbidity and mortality in the victim of trauma. Currently, there is no method that is clinically practical and accurate for predicting the occurrence of sepsis in trauma victims.


METHODS
Data were collected on 3,759 motor-vehicle crash victims from 16 hospitals during a 4 1/2 year period. Retrospective analysis was done to examine the relationship of patient and injury factors known within the first 24 hours of admission on the development of sepsis.


RESULTS
Sepsis developed in 154 patients (4.1%) who had a mortality rate of 17.5%. Significant early predictors of sepsis included: 1) certain pre-existing conditions; 2) blood transfusion required; 3) seven or more injuries; 4) Glasgow Coma Scale score <10 and hypotension [corrected]; 5) major blood vessel injury; 6) head trauma; 7) internal injury of the chest or abdomen; 8) spinal-cord injury; and 9) certain fracture types.


CONCLUSIONS
These predictors might help target high-risk patients and, thus, promote earlier and more effective treatment for those patients.
Previdi
J K
JK
Institute for Trauma and Emergency Care, New York Medical College, Valhalla, New York, USA.
Cayten
C G
CG
Byrne
D W
DW
D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology; D015599:Trauma Severity Indices; D014946:Wound Infection / Q000453:epidemiology* / Q000209:etiology; D014947:Wounds and Injuries / Q000150:complications*