title: Early predictors of prolonged mechanical ventilation in major torso trauma patients who require resuscitation.
abstract: BACKGROUND
  The study purpose was to identify early predictors of prolonged mechanical ventilation in major torso trauma patients.
  
  
  METHODS
  This was a retrospective review of torso trauma patients who met specific criteria for shock resuscitation and required 48 hours of mechanical ventilation. Independent variables evaluated included patient demographics, injury characteristics, and initial 24-hour resuscitation parameters. Univariate and multivariate logistic regression analyses were performed using a significance level of P <.05.
  
  
  RESULTS
  Over 59 months, 224 patients met study criteria. Age was 34 years (range 25 to 69), 68% were male, 78% sustained blunt trauma, and injury severity score was 27 (range 18 to 38). Thirty-three percent required prolonged mechanical ventilation. In the analysis, predictors of prolonged mechanical ventilation included total fluid resuscitation, facial trauma, age, positive end-expiratory pressure > or =10 mm Hg on admission, arterial partial pressure of oxygen divided by the fraction of inspired oxygen ratio less than 300 at 24 hours, and chest abbreviated injury scale score.
  
  
  CONCLUSIONS
  The need for prolonged mechanical ventilation can be accurately predicted and these predictors may assist clinicians in resource allocation and patient management decisions.
authors.affiliation: Department of Surgery, Eastern Carolina University, Greenville, NC, USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Agle
authors.forename: Lillian S
authors.initials: LS
authors.lastname: Kao
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Moore
authors.forename: Ernest A
authors.initials: EA
authors.lastname: Gonzalez
authors.forename: Gary A
authors.initials: GA
authors.lastname: Vercruysse
authors.forename: S Rob
authors.initials: SR
authors.lastname: Todd
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012121:Respiration, Artificial; D012151:Resuscitation; D012189:Retrospective Studies; D013997:Time Factors; D014139:Tracheostomy; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000628:therapy*