Early risk factors for sepsis in patients with severe blunt trauma.
We studied 43 patients with blunt trauma (injury severity score, > or =25), age >14 years and length of the intensive care unit (ICU) stay >48 h in order to estimate the frequency of sepsis and to identify early risk factors related to its development. Clinical data were collected during the first 24 h and several inflammatory mediators were determined from serum samples of the first 2 days after injury.Twenty-one patients (48.8%) met sepsis criteria during their ICU stay, 9 (20.9%) fulfilled only criteria for sepsis; 6 (13.9%) fulfilled criteria for severe sepsis and another 6 (13.9%) criteria for septic shock. An APACHE II score > or =14, the presence of hypovolemic shock, the need for three or more units of blood to be transfused and the administration of a total volume of fluids > or =10 l were all factors associated significantly with the development of sepsis. In the multivariant analysis, the need for a total volume of fluids > or =10 l was the only independent risk factor (adjusted odds ratio=10.49, 95% CI, 2.34-47.02; P=0.002). No significant differences were documented in relation to the behaviour of the serum markers.
Flores
J M
JM
Department of Critical Care and Emergency Medicine, Servicio de Cuidados Críticos y Urgencias (UCI-HRT), Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot s/n, 41013, Sevilla, Spain.
Jiménez
P I
PI
Rincón
M D
MD
Márquez
J A
JA
Navarro
H
H
Arteta
D
D
Murillo
F
F
D000328:Adult; D001803:Blood Transfusion / Q000706:statistics & numerical data; D003422:Critical Care; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology*; D014949:Wounds, Nonpenetrating / Q000150:complications*
D018836:Inflammation Mediators