Pneumonia in severely injured patients with thoracic trauma : results of a retrospective observational multi-centre study

  • Background: While the incidence and aspects of pneumonia in ICU patients has been extensively discussed in the literature, studies on the occurrence of pneumonia in severely injured patients are rare. The aim of the present study is to elucidate factors associated with the occurrence of pneumonia in severely injured patients with thoracic trauma. Setting: Level-I University Trauma Centres associated with the TraumaRegister DGU®. Methods: A total of 1162 severely injured adult patients with thoracic trauma documented in the TraumaRegister DGU® (TR-DGU) were included in this study. Demographic data, injury severity, duration of mechanical ventilation (MV), duration of ICU stay, occurrence of pneumonia, bronchoalveolar lavage, aspiration, pathogen details, and incidences of mortality were evaluated. Statistical evaluation was performed using SPSS (Version 25.0, SPSS, Inc.) software. Results: The overall incidence of pneumonia was 27.5%. Compared to patients without pneumonia, patients with pneumonia had sustained more severe injuries (mean ISS: 32.6 vs. 25.4), were older (mean age: 51.3 vs. 47.5) and spent longer periods under MV (mean: 368.9 h vs. 114.9 h). Age, sex (male), aspiration, and duration of MV were all independent predictors for pneumonia occurrence in a multivariate analysis. The cut-off point for duration of MV that best discriminated between patients who would and would not develop pneumonia during their hospital stay was 102 h. The extent of thoracic trauma (AISthorax), ISS, and presence of pulmonary comorbidities did not show significant associations to pneumonia incidence in our multivariate analysis. No significant difference in mortality between patients with and without pneumonia was observed. Conclusions: Likelihood of pneumonia increases with age, aspiration, and duration of MV. These parameters were not found to be associated with differences in outcomes between patients with and without pneumonia. Future studies should focus on independent parameters to more clearly identify severely injured subgroups with a high risk of developing pneumonia. Level of evidence: Level II - Retrospective medical record review.

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Author:Sebastian Wutzler, Felix Marius Bläsius, Philipp StörmannORCiDGND, Thomas LustenbergerORCiDGND, Michael Frink, Marc Maegele, Matthias Weuster, Jörg Bayer, Michael Caspers, Andreas Seekamp, Ingo MarziORCiDGND, Hagen Andruszkow, Frank Hildebrand
URN:urn:nbn:de:hebis:30:3-488108
DOI:https://doi.org/10.1186/s13049-019-0608-4
ISSN:1757-7241
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/30871601
Parent Title (English):Scandinavian journal of trauma, resuscitation and emergency medicine
Publisher:BioMed Central
Place of publication:London
Document Type:Article
Language:English
Year of Completion:2019
Date of first Publication:2019/03/14
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2019/04/02
Tag:AIS; ICU; ISS; Pneumonia; Thoracic trauma
Volume:27
Issue:1, Art. 31
Page Number:10
First Page:1
Last Page:10
Note:
Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
HeBIS-PPN:448057468
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 4.0