Heather Rhodes, DHS,RT(R)(ARRT)CT
Trauma Research Specialist
Grand Strand Medical Center
Myrtle Beach, South Carolina, United States
Disclosure information not submitted.
Saptarshi Biswas, MD, FRCS, FACS, FICS
Attending Surgeon,Department of Trauma,Acute Care Surgery,Surgical Critical Care
GSRMC- Ocean View Education Center
Myrtle Beach, SC
Disclosure information not submitted.
Heather De La Cruz, RRT/RCP
Respiratory Therapist
Grand Strand Medical Center, United States
Disclosure information not submitted.
Rachel Cobos, MD
Trauma Surgeon
Grand Strand Medical Center, United States
Disclosure information not submitted.
Tara DiNitto, MD
Trauma Surgeon
Grand Strand Medical Center, United States
Disclosure information not submitted.
Antonio Pepe, MD,FACS,FRCSC
Trauma Surgeon
Grand Strand Medical Center, United States
Disclosure information not submitted.
Title: Do Level of Trauma Activations, Demographics, Comorbidities, and Injury Patterns Determine Outcome?
Introduction: The intensive care unit provides health care services to the most critically unstable patients seen in trauma. The purpose of this study is to define those patients who are most at-risk for worsening outcomes in the critical care setting.
Methods: A retrospective cohort study of trauma registry data, inclusive years, July 1, 2016, to March 21, 2021. Patients were grouped based upon hospital length of stay, intensive care unit length of stay, ED disposition, and ventilation length in days. Each grouping was compared with injury patterns, morbidity, and mortality using Wilcoxon-Kruskal Wallis or Pearson's Chi-square tests in R software.
Results: A total of 4881 ICU trauma patients were included in this study sample. Patients with longer hospital length of stays had a higher probability of Level II activations (p < 0.01) with a diagnosis of advanced directive limiting care (p=0.02), and congestive heart failure/MI/peripheral artery disease (p < 0.01). Patients with a longer ICU length of stay and who were most likely to expire in-hospital were those with a trauma consult activation (p < 0.01), with bicycle/moped/ATV/water-related/MCC mode of injury (p < 0.01; expire), and a comorbidity of bleeding disorder (p < 0.01) and CVA (p=0.03). Those ICU patients with the longest ventilation days were more likely to be African American (p < 0.01), a Level I trauma (p < 0.01) with bicycle/moped/ATV/water-related/MCC (p < 0.01).
Conclusions: There is some variability in severity of mortality and morbidity in the level of trauma activation and comorbidities; however, those patients with bicycle/moped/ATV/water-related/MCC mode of injury have the highest occurrence in worsening outcomes in the critical care setting among this dataset.