Courtney M Collins, Anahita Jalilvand, Whitney Kellett, Holly Baselice, Jon Wisler
{"title":"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。","authors":"Courtney M Collins, Anahita Jalilvand, Whitney Kellett, Holly Baselice, Jon Wisler","doi":"10.1016/j.amjsurg.2025.116618","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis and trauma are leading causes of mortality. We hypothesize that antecedent trauma contributes to worse outcomes.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"116618"},"PeriodicalIF":2.7000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Antecedent traumatic injuries independently predict higher 90-day mortality for patients admitted to the ICU with surgical sepsis.\",\"authors\":\"Courtney M Collins, Anahita Jalilvand, Whitney Kellett, Holly Baselice, Jon Wisler\",\"doi\":\"10.1016/j.amjsurg.2025.116618\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Sepsis and trauma are leading causes of mortality. We hypothesize that antecedent trauma contributes to worse outcomes.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":7771,\"journal\":{\"name\":\"American journal of surgery\",\"volume\":\"250 \",\"pages\":\"116618\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-09-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.amjsurg.2025.116618\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amjsurg.2025.116618","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Antecedent traumatic injuries independently predict higher 90-day mortality for patients admitted to the ICU with surgical sepsis.
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.
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.
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