@article{ref1,
title="Relationship between intensive care complications and costs and initial 24 h events of trauma patients with severe haemorrhage",
journal="Emergency medicine journal",
year="2009",
author="Husari, A. W. and Belzberg, H. and Kassak, Kassem and Dunham, C. M.",
volume="26",
number="5",
pages="340-343",
abstract="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.<p /> <p>Language: en</p>",
language="en",
issn="1472-0205",
doi="10.1136/emj.2008.058214",
url="http://dx.doi.org/10.1136/emj.2008.058214"
}