Antecedent traumatic injuries independently predict higher 90-day mortality for patients admitted to the ICU with surgical sepsis.

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-09-17 DOI:10.1016/j.amjsurg.2025.116618

Courtney M Collins, Anahita Jalilvand, Whitney Kellett, Holly Baselice, Jon Wisler

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引用次数: 0

Abstract

Introduction: Sepsis and trauma are leading causes of mortality. We hypothesize that antecedent trauma contributes to worse outcomes.

Methods: A single-institution retrospective study of patients admitted to the SICU between September 2013-January 2019 who met Sepsis III criteria. 1401 patients were included, 7.8 % (n = 106) had preceding trauma. Cox regression was used to model in-hospital death and 90-day mortality. Kaplan-Meier 90- Day Survival Curve was calculated based on trauma status.

Results: Antecedent trauma was associated with in-hospital mortality (p = 0.03). Trauma, transfer status, age, Charlson comorbidity index, admission lactate and SOFA score were all independent predictors of in-hospital and 90-day mortality (p < 0.005). 90-day survival curve showed a trend towards decreasing survival for the trauma cohort (p = 0.02).

Conclusion: Our findings indicate antecedent trauma may have significant impact on patient outcomes. Further investigation is necessary to explore the underlying mechanisms linking trauma and sepsis.

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先前的创伤性损伤独立预测了ICU手术败血症患者较高的90天死亡率。

败血症和创伤是导致死亡的主要原因。我们假设先前的创伤会导致更糟糕的结果。方法：对2013年9月至2019年1月期间入住SICU的符合脓毒症III标准的患者进行单机构回顾性研究。纳入1401例患者，7.8% （n = 106）有外伤史。采用Cox回归对院内死亡和90天死亡率进行建模。根据创伤状态计算Kaplan-Meier 90天生存曲线。结果：先前创伤与住院死亡率相关（p = 0.03）。外伤、转院状态、年龄、Charlson合并症指数、入院乳酸和SOFA评分均为住院死亡率和90天死亡率的独立预测因子（p < 0.005）。90天生存曲线显示创伤组生存率有下降趋势（p = 0.02）。结论：我们的研究结果表明，先前的创伤可能对患者的预后有显著影响。有必要进一步研究创伤与败血症之间的潜在机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.