title: Infectious complications of noncombat trauma patients provided care at a military trauma center.
abstract: Infectious complications are reported frequently in combat trauma patients treated at military hospitals. Infections in 4566 noncombat related trauma patients treated at a military trauma center were retrospectively reviewed from 1/2003 to 5/2007 using registry data. Burns, penetrating, and blunt trauma accounted for 17%, 19%, and 64%, respectively; the median age was 38 and 22% were female. Pulmonary infections were present in 4.2% of patients, 2.4% had cellulitis and wound infections, 2.2% urinary infections, and 0.7% sepsis. On univariate analysis, infected patients were more likely to be admitted to the ICU, have longer ICU and hospital lengths of stay (LOS), and to die (p < 0.05). Multivariate analysis revealed associations between infection and hospital LOS, preexisting medical conditions, and lower Glasgow Coma Scale in nonburned patients. In burned patients, infection was associated with total body surface area burned and preexisting conditions (p < 0.01). Enhanced infection control in targeted trauma populations may improve outcomes.
authors.affiliation: San Antonio Military Medical Center, Fort Sam Houston, TX, USA.
authors.forename: Heather C
authors.initials: HC
authors.lastname: Yun
authors.forename: Lorne H
authors.initials: LH
authors.lastname: Blackbourne
authors.forename: John A
authors.initials: JA
authors.lastname: Jones
authors.forename: John B
authors.initials: JB
authors.lastname: Holcomb
authors.forename: Duane R
authors.initials: DR
authors.lastname: Hospenthal
authors.forename: Steven E
authors.initials: SE
authors.lastname: Wolf
authors.forename: Evan M
authors.initials: EM
authors.lastname: Renz
authors.forename: Clinton K
authors.initials: CK
authors.lastname: Murray
mesh_terms: D015998:Abbreviated Injury Scale; D000328:Adult; D003141:Communicable Diseases / Q000453:epidemiology / Q000209:etiology*; D016021:Epidemiologic Studies; D005260:Female; D015600:Glasgow Coma Scale; D006772:Hospitals, Military / Q000706:statistics & numerical data*; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008887:Military Medicine / Q000458:organization & administration / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000150:complications* / Q000453:epidemiology