TY  - JOUR
PY  - 2011//
TI  - Damage control in severely injured trauma patients - A ten-year experience
JO  - Journal of emergencies, trauma and shock
A1  - Frischknecht, Andreas
A1  - Lustenberger, Thomas
A1  - Bukur, Marko
A1  - Turina, Matthias
A1  - Billeter, Adrian
A1  - Mica, Ladislav
A1  - Keel, Marius
SP  - 450
EP  - 454
VL  - 4
IS  - 4
N2  - BACKGROUND: This study reviews our 10-year institutional experience with damage control management and investigates risk factors for early mortality. MATERIALS AND METHODS: The trauma registry of our level I trauma centre was utilized to identify all patients from 01/96 through 12/05 who underwent initial damage control procedures. Demographics, clinical and physiological parameters, and outcomes were abstracted. Patients were categorized as either early survivors (surviving the first 72 hours after admission) or early deaths. RESULTS: During the study period, 319 patients underwent damage control management. Overall, 52 patients (16.3%) died (early deaths) and 267 patients (83.7%) survived the first 72 hours (early survivors). Early deaths showed significantly deranged serum lactate (5.81±0.55 vs. 3.46±0.13 mmol/L; P<0.001), base deficit (10.10±0.95 vs. 4.90±0.28 mmol/L; P<0.001) and pH (7.16±0.03 vs. 7.29±0.01; P<0.001) levels compared to early survivors on hospital admission. An International Normalized Ratio >1.2, base deficit >3 mmol/L, head Abbreviated Injury Scale ≥3, body temperature <35°C, serum lactate >6 mmol/L, and hemoglobin <7 g/dL proved to be independent risk factors for early mortality on hospital admission. CONCLUSIONS: Several risk factors for early mortality such as severe head injury and the lethal triad (coagulopathy, acidosis and hypothermia) in patients undergoing damage control procedures were identified and should trigger the trauma surgeon to maintain aggressive resuscitation in the intensive care unit.<p />  <p>Language: en</p>
LA  - en
SN  - 0974-2700
UR  - http://dx.doi.org/10.4103/0974-2700.86627
ID  - ref1
ER  -