Risk factors for infection and evaluation of Sepsis-3 in patients with trauma. Am J Surg 2019 Nov;218(5):851-857
Date
03/20/2019Pubmed ID
30885453Pubmed Central ID
PMC6732249DOI
10.1016/j.amjsurg.2019.03.005Scopus ID
2-s2.0-85062898983 (requires institutional sign-in at Scopus site) 18 CitationsAbstract
BACKGROUND: We aim to examine the risk factors associated with infection in trauma patients and the Sepsis-3 definition.
METHODS: This was a retrospective cohort study of adult trauma patients admitted to a Level I trauma center between January 2014 and January 2016.
RESULTS: A total of 1499 trauma patients met inclusion criteria and 15% (n = 232) had an infection. Only 19.8% (n = 46) of infected patients met criteria for Sepsis-3, with the majority (43%) of infected cases having a Sequential Organ Failure Assessment (SOFA) score greater on admission compared to the time of suspected infection. In-hospital death was 7% vs 9% (p = 0.65) between Sepsis-3 and infected patients, respectively. Risk factors associated with infection were female sex, admission SOFA score, Elixhauser score, and severe injury (P < 0.05).
CONCLUSION: Patients with trauma often arrive with organ dysfunction, which adds complexity and inaccuracy to the operational definition of Sepsis-3 using changes in SOFA scores. Injury severity score, comorbidities, SOFA score, and sex are risk factors associated with developing an infection after trauma.
Author List
Eguia E, Cobb AN, Baker MS, Joyce C, Gilbert E, Gonzalez R, Afshar M, Churpek MMAuthor
Adrienne Cobb MD Assistant Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Female
Hospital Mortality
Humans
Injury Severity Score
Logistic Models
Male
Middle Aged
Organ Dysfunction Scores
Prognosis
Retrospective Studies
Risk Factors
Sepsis
Wounds and Injuries
Young Adult
