%0 Journal Article
%T Relationship between intensive care complications and costs and initial 24 h events of trauma patients with severe haemorrhage
%J Emergency medicine journal
%D 2009
%A Husari, A. W.
%A Belzberg, H.
%A Kassak, Kassem
%A Dunham, C. M.
%V 26
%N 5
%P 340-343
%X 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>
%G en
%I BMJ Publishing Group
%@ 1472-0205
%U http://dx.doi.org/10.1136/emj.2008.058214