Outcome after hemorrhagic shook in trauma patients

Susan R. Heckbert; Nicholas B. Vedder; Wilma Hoffman; Robert K. Winn; Leonard D. Hudson; Gregory Jurkovich; Michael K. Copass; John M. Harlan; Charles L. Rice; Ronald V. Maier

doi:10.1097/00005373-199809000-00022

Outcome after hemorrhagic shook in trauma patients

Susan R. Heckbert, Nicholas B. Vedder, Wilma Hoffman, Robert K. Winn, Leonard D. Hudson, Gregory Jurkovich, Michael K. Copass, John M. Harlan, Charles L. Rice, Ronald V. Maier

Research output: Contribution to journal › Article › peer-review

292 Scopus citations

Abstract

Background: It is essential to identify patients at high risk of death and complications for future studies of interventions to decrease reperfusion injury. Methods: We conducted an inception cohort study at a Level I trauma center to determine the rates and predictors of death, organ failure, and infection in trauma patients with systolic blood pressure ≤ 90 mm Hg in the field or in the emergency department. Results: Among the 208 patients with hemorrhagic shock (blood pressure ≤ 90 mm Hg), 31% died within 2 hours of emergency department arrival, 12% died between 2 and 24 hours, 11% died after 24 hours, and 46% survived. Among those who survived ≤ 24 hours, 39% developed infection and 24% developed organ failure. Increasing volume of crystalloid in the first 24 hours was strongly associated with increased mortality (p = 0.00001). Conclusion: Hemorrhage-induced hypotension in trauma patients is predictive of high mortality (54%) and morbidity. The requirement for large volumes of crystalloid was associated with increased mortality.

Original language	English (US)
Pages (from-to)	545-549
Number of pages	5
Journal	Journal of Trauma - Injury, Infection and Critical Care
Volume	45
Issue number	3
DOIs	https://doi.org/10.1097/00005373-199809000-00022
State	Published - Sep 1 1998
Externally published	Yes

Keywords

Cohort studies
Injury Severity Score
Mortality
Multiple organ failure
Risk factors
Wounds and injuries

ASJC Scopus subject areas

Surgery
Critical Care and Intensive Care Medicine

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Outcome after hemorrhagic shook in trauma patients. / Heckbert, Susan R.; Vedder, Nicholas B.; Hoffman, Wilma; Winn, Robert K.; Hudson, Leonard D.; Jurkovich, Gregory; Copass, Michael K.; Harlan, John M.; Rice, Charles L.; Maier, Ronald V.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 45, No. 3, 01.09.1998, p. 545-549.

Research output: Contribution to journal › Article › peer-review

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AU - Vedder, Nicholas B.

AU - Hoffman, Wilma

AU - Winn, Robert K.

AU - Hudson, Leonard D.

AU - Jurkovich, Gregory

AU - Copass, Michael K.

AU - Harlan, John M.

AU - Rice, Charles L.

AU - Maier, Ronald V.

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AB - Background: It is essential to identify patients at high risk of death and complications for future studies of interventions to decrease reperfusion injury. Methods: We conducted an inception cohort study at a Level I trauma center to determine the rates and predictors of death, organ failure, and infection in trauma patients with systolic blood pressure ≤ 90 mm Hg in the field or in the emergency department. Results: Among the 208 patients with hemorrhagic shock (blood pressure ≤ 90 mm Hg), 31% died within 2 hours of emergency department arrival, 12% died between 2 and 24 hours, 11% died after 24 hours, and 46% survived. Among those who survived ≤ 24 hours, 39% developed infection and 24% developed organ failure. Increasing volume of crystalloid in the first 24 hours was strongly associated with increased mortality (p = 0.00001). Conclusion: Hemorrhage-induced hypotension in trauma patients is predictive of high mortality (54%) and morbidity. The requirement for large volumes of crystalloid was associated with increased mortality.

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Outcome after hemorrhagic shook in trauma patients

Abstract

Keywords

ASJC Scopus subject areas

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