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 journalArticlepeer-review

289 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 languageEnglish (US)
Pages (from-to)545-549
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume45
Issue number3
DOIs
StatePublished - Sep 1 1998
Externally publishedYes

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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