Risk factors for the mortality of trauma victims in the intensive care unit

Abstract

Objective: To identify the risk factors associated with mortality of trauma victims during hospitalisation in the intensive care unit (ICU).

Design: Prospective cohort.

Setting: Brazilian ICU specialising in the care of trauma victims.

Methods: The subjects were divided into two groups: survivors and non-survivors. The variables used to compare the groups included demographic and clinical characteristics and illness/injury severity (Acute Physiology and Chronic Health Evaluation [APACHE II], Simplified Acute Physiology Score [SAPS II], Logistic Organ Dysfunction System [LODS], Injury Severity Score [ISS] and New Injury Severity Score [NISS]). The data were analysed using descriptive and inferential statistics and multiple logistic regression analysis.

Results: The sample consisted of 200 patients (164 males) with a mean age of 40.7 years. The predominant causes of injury were traffic accidents (57.5%) followed by falls (31.0%). The ICU mortality was 19.0%. Logistic regression analysis revealed that one point on the NISS and SAPS II scores increased the risk of death by 6% and 7%, respectively. In contrast, the risk of dying decreased 4% for each day of ICU hospitalisation.

Conclusion: Professionals must use the SAPS II and NISS for the early identification of trauma victims at high risk for death especially during the first days of ICU hospitalisation.

Keywords: Intensive care unit; Mortality; Severity of illness index; Trauma severity indices; Wounds and injuries.