Risk Factors for Cytomegalovirus Gastrointestinal Disease in Patients with Trauma.

Abstract

Background: This study investigated the clinical characteristics and risk factors for cytomegalovirus (CMV) gastrointestinal (GI) disease in patients with trauma using covariate matching.

Patients and methods: This study included immunocompetent patients with trauma who had received a diagnosis of CMV GI disease between 2017 and 2022, confirmed by symptoms and quantitative real-time polymerase chain reaction. Patients were matched 3:1 on the basis of age, gender, mechanism of injury, Injury Severity Score, and Trauma and Injury Severity Score. Matched cases were compared using χ² or Fisher exact test and the Mann-Whitney U test. Significant variables identified during uni-variable analysis were entered into logistic regression.

Results: A total of 23 patients received a diagnosis of CMV GI disease. After matching, 22 CMV-positive and 62 CMV-negative patients were analyzed. CMV-positive patients frequently underwent hollow viscus (HV) organ surgery (p = 0.028) and pre-peritoneal pelvic packing (PPP) (p = 0.012). The disease-positive group also exhibited a greater demand for mechanical ventilation, stress-dose steroids, renal replacement therapy (RRT) (all p < 0.001), and a greater blood product requirement within 24 h (p = 0.007). Logistic regression identified HV organ surgery (OR: 6.65, 95% confidence interval [CI]: 1.34-32.89, p = 0.020), PPP (OR: 12.58, 95% CI: 1.14-139.15, p = 0.039), stress-steroid use (OR: 8.31, 95% CI: 1.15-47.40, p = 0.017), and RRT (OR: 15.72, 95% CI: 3.02-81.81, p = 0.001) as risk factors for the disease.

Conclusions: This study identified HV organ surgery, PPP, steroid usage, and RRT as significant risk factors for CMV GI disease in patients with trauma.