American journal of disaster medicine · 2021
Medical planning for disaster response: Identifying risk factors for developing adult respiratory distress syndrome among trauma patients.
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Keneally Ryan J, Hubbard Mark C, Hawkins Katrina, Davison Danielle, Berger Jeffrey S
Аннотация
INTRODUCTION: Adult respiratory distress syndrome (ARDS) is a well-described complication of critical illness. We hy-pothesized that rates of comorbid diseases in a population may influence the risk for developing ARDS in trauma pa-tients. This can help plan medical responses.
METHODS: Patients from the 2017 National Trauma Databank were analyzed. Inclusion criteria were an injury sever-ity score (ISS) of ≥ 2 and 1 or more documented days of mechanical ventilation. Data were analyzed using χ2, Student's t test, Mann-Whitney U test, or logistic regression as indicated.
RESULTS: Diabetes (odds ratio [OR] 1.33, 95 percent confidence interval [CI] 1.17-1.52), smoking (OR 1.26, 95 per-cent CI 1.13-1.40), transfusion (OR 1.20, 95 percent CI 1.09-1.32), ISS (OR 1.02, 95 percent CI 1.02-1.03), male gen-der (OR 1.22, 95 percent CI 1.10-1.35), decreasing Glasgow coma score (OR 1.04, 95 percent CI 1.03-1.05), and in-creasing abbreviated injury score of the thorax (OR 1.12, 95 percent CI 1.09-1.16) were associated with an increase in risk for developing ARDS.
CONCLUSION: Diabetes and smoking are risk factors for developing ARDS after trauma. Medical response planning in countries with high rates of diabetes mellitus or smoking should take into account a greater need for intensive care and longer patient admissions to field hospitals.
METHODS: Patients from the 2017 National Trauma Databank were analyzed. Inclusion criteria were an injury sever-ity score (ISS) of ≥ 2 and 1 or more documented days of mechanical ventilation. Data were analyzed using χ2, Student's t test, Mann-Whitney U test, or logistic regression as indicated.
RESULTS: Diabetes (odds ratio [OR] 1.33, 95 percent confidence interval [CI] 1.17-1.52), smoking (OR 1.26, 95 per-cent CI 1.13-1.40), transfusion (OR 1.20, 95 percent CI 1.09-1.32), ISS (OR 1.02, 95 percent CI 1.02-1.03), male gen-der (OR 1.22, 95 percent CI 1.10-1.35), decreasing Glasgow coma score (OR 1.04, 95 percent CI 1.03-1.05), and in-creasing abbreviated injury score of the thorax (OR 1.12, 95 percent CI 1.09-1.16) were associated with an increase in risk for developing ARDS.
CONCLUSION: Diabetes and smoking are risk factors for developing ARDS after trauma. Medical response planning in countries with high rates of diabetes mellitus or smoking should take into account a greater need for intensive care and longer patient admissions to field hospitals.