title: Resuscitation with polymeric plasma substitutes is permissive for systemic inflammatory response syndrome and sepsis in multiply injured patients: a retrospective cohort study.
abstract: OBJECTIVE
  Multiple trauma is often accompanied by systemic inflammatory response syndrome (SIRS). The aim of this study was to investigate the impact of polymeric plasma substitutes on the development of SIRS or sepsis.
  
  
  METHODS
  We included 2969 patients aged ≥16 years with an Injury Severity Score (ISS) >16 in this study. The sample was subdivided into three groups: patients who did not receive colloids and those who received <5L colloids and >5L colloids within the first 48 h. Data were analyzed using IBM SPSS®for Windows version 22.0; analysis of variance was used for continuous normally distributed data and Kruskal-Wallis test for categorical data. The predictive quality of colloid treatment was analyzed using the receiver operating characteristic (ROC) curves. Independent predictively was analyzed by binary logistic regression. Data were considered significant if P < 0.05. Data are presented as the mean ± standard deviation.
  
  
  RESULTS
  The SIRS score increased with the amount of colloid used (1.9 ± 1.4 vs. 2.4 ± 1.2 vs. 3.2 ± 0.9; P < 0.001). However, the predictive quality was low, with an area under the ROC of 0.693 for SIRS and 0.669 for sepsis (P < 0.001). Binary logistic regression revealed colloids as an independent factor for the development of SIRS and sepsis (odds ratios: SIRS 3.325 and sepsis 8.984; P < 0.001).
  
  
  CONCLUSIONS
  Besides other factors, colloids have a significant permissive effect and are independent predictors for the development of SIRS and sepsis in multiply injured patients. Trial registration 'Retrospektive Analysen in der Chirurgischen Intensivmedizin' No. St. V. 01-2008.
authors.affiliation: Division of Trauma Surgery, University Hospital of Zürich, Rämistrasse 100, 8091, Zurich, Switzerland.
authors.forename: Kai
authors.initials: K
authors.lastname: Sprengel
authors.affiliation: Division of Trauma Surgery, University Hospital of Zürich, Rämistrasse 100, 8091, Zurich, Switzerland.
authors.forename: Hanspeter
authors.initials: H
authors.lastname: Simmen
authors.affiliation: Division of Trauma Surgery, University Hospital of Zürich, Rämistrasse 100, 8091, Zurich, Switzerland.
authors.forename: Clément M L
authors.initials: CM
authors.lastname: Werner
authors.affiliation: Institute of Anesthesiology, University Hospital of Zürich, 8091, Zurich, Switzerland.
authors.forename: Simon
authors.initials: S
authors.lastname: Sulser
authors.affiliation: Division of Trauma Surgery, University Hospital of Zürich, Rämistrasse 100, 8091, Zurich, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Plecko
authors.affiliation: LVR Klinik Köln, 51109, Cologne, Germany.
authors.forename: Catharina
authors.initials: C
authors.lastname: Keller
authors.affiliation: Division of Trauma Surgery, University Hospital of Zürich, Rämistrasse 100, 8091, Zurich, Switzerland. ladislav.mica@usz.ch.
authors.forename: Ladislav
authors.identifier: http://orcid.org/0000-0002-7246-1266
authors.initials: L
authors.lastname: Mica
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000379:methods; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications / Q000401:mortality / Q000628:therapy; D010952:Plasma Substitutes / Q000627:therapeutic use*; D012151:Resuscitation / Q000379:methods*; D012189:Retrospective Studies; D018805:Sepsis / Q000401:mortality / Q000628:therapy*; D018746:Systemic Inflammatory Response Syndrome / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D010952:Plasma Substitutes
keywords: Hydroxyethyl starch derivatives; Multiple trauma; Sepsis; Systemic inflammatory response syndrome