[Predictors of mortality in critically multiple trauma patients after damage control surgery].
OBJECTIVE
To investigate the efficiency of damage control surgery (DCS) and predictors of mortality in critically multiple trauma patients.


METHODS
From May 1998 to February 2007, DCS were carried out in 27 patients with critically multiple trauma. Of the patients 15 cases survived (survival group) and 12 cases died (dead group). The surgical complications, causes of death, demographic, physiologic and medical parameters were collected and compared between the two groups. Multiple logistic regression analysis were performed to identify possible predictors of mortality.


RESULTS
The incidence of surgical complications was 37.0 percent, and the intra-abdominal infections was the most frequent (18.5%). The overall mortality rate was 44.4 percent. The most common causes of death was multiple organ dysfunction syndrome (50.0%). With respect to predicting mortality, statistically significant differences was found in parameters as age, injury severity score (ISS), initial temperature and base excess (BE), estimated blood loss, initial ICU temperature and length of hospital stay. Older age, increased absolute value of initial BE and lower initial ICU temperature were determined as independent predictors of mortality on multiple logistic regression analysis.


CONCLUSIONS
There is a comparable high morbidity and mortality rate in severely injured patients managed with DCS. Increased age, a larger absolute value of initial BE and lower initial ICU temperature could independently predict death of the patients.
Shen
Xiao-jun
XJ
Department of General Surgery, Changhai Hospital, the Second Military Medical University, Shanghai 200433, China. shenxj@medmail.com.cn
Xue
Xu-chao
XC
Wang
Yao
Y
Zhang
Hao
H
Zhi
Kang-kang
KK
Bi
Jian-wei
JW
Fang
Guo-en
GE
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000401:mortality / Q000601:surgery*; D015999:Multivariate Analysis; D011183:Postoperative Complications; D011379:Prognosis; D013696:Temperature; D055815:Young Adult