title: Sepsis in intensive care unit patients with traumatic brain injury: factors associated with higher mortality.
abstract: OBJECTIVE
  Patients with traumatic brain injury are particularly susceptible to sepsis, which may exacerbate the systemic inflammatory response and lead to organ dysfunction. The influence of clinical variables on the mortality of intensive care unit patients with traumatic brain injury and sepsis was investigated.
  
  
  METHODS
  The present investigation was a retrospective study involving 175 patients with traumatic brain injury who were treated in a period of 1 year at a reference hospital for trauma and who had sepsis, severe sepsis, or septic shock. Demographic and clinical data were obtained, and the SOFA score was calculated at the time sepsis was found and after 72 hours.
  
  
  RESULTS
  There was a predominance of young men with severe traumatic brain injury, multiple head injuries, sepsis with a pulmonary focus, prolonged hospital stay, and high mortality (37.7%). Circulatory and respiratory failure had a high incidence, but renal and coagulation failure were less frequent, and liver failure was not observed. After logistic regression, the presence of septic shock and respiratory failure 72 hours after the sepsis diagnosis was associated with higher mortality, with an odds ratio of 7.56 (95%CI=2.04-27.31, p=0.0024) and 6.62 (95%CI=1.93-22.78, p=0.0027), respectively. In addition, there was a higher mortality among patients who had no organ failure on D1 but who developed the condition after 72 hours of sepsis and in those patients who already had organ failure at the time sepsis was diagnosed and remained in this condition after 72 hours.
  
  
  CONCLUSIONS
  Septic shock and progressive organ (particularly respiratory) dysfunction increases the mortality of patients with traumatic brain injury and sepsis.
authors.affiliation: Curso Acadêmico de Medicina, Faculdade de Medicina, Centro de Ciências Biológicas e Saúde, Universidade do Estado do Pará, Belém, PA, Brasil.
authors.forename: Luis Carlos Maia
authors.initials: LC
authors.lastname: Cardozo Júnior
authors.affiliation: Curso Acadêmico de Medicina, Faculdade de Medicina, Centro de Ciências Biológicas e Saúde, Universidade do Estado do Pará, Belém, PA, Brasil.
authors.forename: Redson Ruy da
authors.initials: RR
authors.lastname: Silva
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D012772:Shock, Septic / Q000150:complications* / Q000401:mortality; D013997:Time Factors; D055815:Young Adult