Document Detail


Relationship between intensive care complications and costs and initial 24 h events of trauma patients with severe haemorrhage.
MedLine Citation:
PMID:  19386867     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The correlation between the events occurring in the initial 24 h following traumatic injury and the outcome of patients presenting with hypovolaemic shock is not clear. METHODS: 27 patients who presented to a regional trauma centre with severe hypovolaemic shock were prospectively monitored. Evidence of severe hypovolaemia and shock was noted on admission with a mean systolic blood pressure of 73.8 mm Hg and a mean lactate level of 6.6 mM/l. The patients received a mean of 21.7 litres intravenous fluids during the first 24 h to maintain a mean systolic blood pressure >or=110 mm Hg and urine output of >or=50 ml/h. Multiple metabolic and physiological parameters were obtained prospectively and on an almost hourly basis for the first 24 h after admission. Patients were followed throughout their stay in hospital to record outcome, complications, total hospital costs and length of stay. RESULTS: Using regression and multivariate analysis, adult respiratory distress syndrome was correlated with hypothermia and persistent lactic acidosis (R(2) = 0.65, p = 0.005). Coagulopathy was associated with hypothermia (R(2) = 0.43, p = 0.04). Length of stay and cost of hospitalisation were highly related to intensive care unit days, hospital-acquired infections and ventilator days (R(2) = 0.86, p = 0.03). CONCLUSION: The initial 24 h events of trauma patients with haemorrhagic shock may have a significant impact on hospital costs and on complications developing later during hospitalisation.
Authors:
A W Husari; H Belzberg; K Kassak; C M Dunham
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Emergency medicine journal : EMJ     Volume:  26     ISSN:  1472-0213     ISO Abbreviation:  Emerg Med J     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-23     Completed Date:  2009-06-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963089     Medline TA:  Emerg Med J     Country:  England    
Other Details:
Languages:  eng     Pagination:  340-3     Citation Subset:  IM    
Affiliation:
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, American University of Beirut-Medical Center, P O Box 113-6044, Beirut 1107 2802, Lebanon. ah51@aub.edu.lb
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MeSH Terms
Descriptor/Qualifier:
Adult
Health Services Research / methods
Hemorrhage / economics*,  etiology,  therapy
Hospital Costs / statistics & numerical data*
Humans
Intensive Care / economics*
Length of Stay / statistics & numerical data
Maryland
Middle Aged
Monitoring, Physiologic / methods
Prognosis
Prospective Studies
Shock / economics,  etiology,  therapy
Time Factors
Trauma Centers / economics
Treatment Outcome
Wounds and Injuries / complications,  economics*,  therapy
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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