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Citation |
Michelet P, Couret D, Brégeon F, Perrin G, Dʼjourno XB, Pequignot V, Vig V, Auffray JP. J. Trauma 2010; 68(2): 395-400. |
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Affiliation |
Réanimation des Urgences, and Service de Chirurgie Thoracique, Hôpital Sainte Marguerite, Université de la Méditerranée; and UMR MD2, Institut Jean Roche, Université de la Méditerranée, Marseille, France. |
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Copyright |
(Copyright © 2010, Lippincott Williams and Wilkins) |
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DOI |
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PMID |
20154552 |
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Abstract |
BACKGROUND:: The development of an early-onset pneumonia (EOP), occurring within the first 72 hours after admission, represents a critical event in severe thoracic trauma population. The aim of this study was to determine risk factors associated with the occurrence of this complication in this specific population. METHODS:: A retrospective review of a prospective implemented trauma registry was conducted during a 4-year period in a Level I trauma center. Over the study period, 223 severely injured patients were admitted with severe thoracic trauma (Injury Severity Score >16 and Thorax Abbreviated Injury Score >2). Multiple logistic regression analysis was used to determine the independent predictors of EOP based on the clinical characteristics and the initial management both in the field and after admission in the trauma center. RESULTS:: Independent predictors of EOP were the necessity of intubation and mechanical ventilation in the field (adjusted odds ratio OR.: 11.8; 95% confidence interval CI.: 4.3-32.7), a history of aspiration (OR: 28.6; 95% CI: 4.0-203.5), the presence of pulmonary contusion (OR: 7.0; 95% CI: 2.0-23.9), and the occurrence of a hemothorax (OR: 3.2; 95% CI: 1.4-7.6). CONCLUSION:: These results emphasize the influence of prehospital and early factors in the further occurrence of EOP, which allows the development of early and specific clinical management to prevent it. Language: en |