Author/Authors :
Akaraborworn, Osaree Division of Trauma and Critical Care - Department of Surgery - Faculty of Medicine - Prince of Songkla University, Hat Yai, Songkhla , Chaiwat, Onuma Department of Anesthesiology - Faculty of Medicine - Prince of Songkla University - Hat Yai, Songkhla , Chatmongkolchart, Sunisa Department of Anesthesiology - Faculty of Medicine - Prince of Songkla University, Hat Yai, Songkhla , Chittawatanarat, Kaweesak Department of Surgery - Faculty of Medicine - Chiang Mai University, Chiang Mai , Kitsiripant, Chanatthee Department of Anesthesiology - Faculty of Medicine - Prince of Songkla University - Hat Yai, Songkhla , Morakul, Sunthiti Department of Anesthesiology - Faculty of Medicine - Ramathibodi Hospital - Mahidol University , Thawitsri, Thammasak Department of Anesthesiology - Faculty of Medicine - King Chulalongkorn Memorial Hospital , Wacharasint, Petch Department of Anesthesiology - Phramongkutklao Hospital , Poopipatpab, Sujaree Department of Anesthesiology - Navamindradhiraj University, Bangkok , Chau‑In, Waraporn Department of Anesthesiology - Faculty of Medicine - Khon Kaen University, Khon Kaen , Kusumaphanyo, Chaiyapruk Department of Anesthesiology - Faculty of Medicine - Srinakharinwirot University, Nakhon Nayok, Thailand
Abstract :
Background: Organ failure (OF) and sepsis are important causes of late death in trauma. Previous studies reported the methods that could
predict OF at the time of patient arrival. However, most of the evidence is from high‑income countries, where health‑care systems were different
from developing countries. This research aimed to identify the factors to predict late complications in trauma patients in surgical intensive
care units (SICUs). Methods: This study was a secondary data analysis from the THAI‑SICU study, which was a prospective cohort study
in nine university‑based‑SICUs in Thailand. Late complications were defined as any OF or sepsis that occurred after 48 h of ICU admission.
Multivariable logistic regression was conducted to identify the significant factors. Results: Three hundred and fourteen patients were eligible
for the analysis. Late complications occurred in 60 patients (19%). Patients who had complications had higher Acute Physiology and Chronic
Health Enquiry (APACHE II) (15.8 vs. 12.4, P = 0.02) and Sequential OF Assessment (SOFA) scores on admission (6.7 vs. 3.8, P < 0.001).
Multivariable analysis showed that current smoking (odds ratio [OR] =1.9, 95% confidence interval [CI]; 1.03–3.67, P = 0.04) and SOFA
score on admission (OR = 1.2, 95% CI; 1.12–1.29, P < 0.001) increased the risk of late complications. Late complications had hazards ratio
of mortality of 5.9 (95% CI; 2.53–13.88, P < 0.001). Conclusions: The incidence of late complications in trauma patients in the SICU was
19%. Current smoking and SOFA score might be valuable in future prediction of late complications during admission.
