Abstract | OBJECTIVE: To identify causes and timing of mortality in trauma patients to determine targets for future studies. BACKGROUND: METHODS: Retrospective review of patients enrolled in multicenter, randomized trials performed from 2006 to 2009. Inclusion criteria were as follows: injured patients, age 15 years or more with hypovolemic shock [systolic blood pressure (SBP) ≤ 70 mm Hg or SBP 71-90 mm Hg with heart rate ≥ 108) or severe TBI [Glasgow Coma Score (GCS) ≤ 8]. Initial fluid administered was 250 mL of either 7.5% saline with 6% dextran 70, 7.5% saline or 0.9% saline. RESULTS: A total of 2061 subjects were enrolled (809 shock, 1252 TBI) and 571 (27.7%) died. Survivors were younger than nonsurvivors [30 (interquartile range 23) vs 42 (34)] and had a higher GCS, though similar hemodynamics. Most deaths occurred despite ongoing resuscitation. Forty-six percent of deaths in the TBI cohort were within 24 hours, compared with 82% in the shock cohort and 72% in the cohort with both shock and TBI. Median time to death was 29 hours in the TBI cohort, 2 hours in the shock cohort, and 4 hours in patients with both. Sepsis and multiple organ dysfunction accounted for 2% of deaths. CONCLUSIONS:
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Authors | Samuel A Tisherman, Robert H Schmicker, Karen J Brasel, Eileen M Bulger, Jeffrey D Kerby, Joseph P Minei, Judy L Powell, Donald A Reiff, Sandro B Rizoli, Martin A Schreiber |
Journal | Annals of surgery
(Ann Surg)
Vol. 261
Issue 3
Pg. 586-90
(Mar 2015)
ISSN: 1528-1140 [Electronic] United States |
PMID | 25072443
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Review)
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Chemical References |
- Saline Solution, Hypertonic
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Topics |
- Brain Injuries
(mortality)
- Hospital Mortality
- Humans
- Multicenter Studies as Topic
- North America
(epidemiology)
- Randomized Controlled Trials as Topic
- Resuscitation
(methods)
- Retrospective Studies
- Risk Factors
- Saline Solution, Hypertonic
(therapeutic use)
- Shock
(mortality)
- Survival Rate
- Time Factors
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