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Relationship between intensive care complications and costs and initial 24 h events of trauma patients with severe haemorrhage

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dc.contributor.author Husari A.W.
dc.contributor.author Belzberg H.
dc.contributor.author Kassak K.
dc.contributor.author Dunham C.M.
dc.contributor.editor
dc.date May-2009
dc.date.accessioned 2017-10-05T15:37:38Z
dc.date.available 2017-10-05T15:37:38Z
dc.date.issued 2009
dc.identifier 10.1136/emj.2008.058214
dc.identifier.isbn
dc.identifier.issn 14720205
dc.identifier.uri http://hdl.handle.net/10938/15846
dc.description.abstract Background: The correlation between the events occurring in the initial 24 h following traumatic injury and the outcome of patients presenting with hypovolaemic shock is not clear. Methods: 27 patients who presented to a regional trauma centre with severe hypovolaemic shock were prospectively monitored. Evidence of severe hypovolaemia and shock was noted on admission with a mean systolic blood pressure of 73.8 mm Hg and a mean lactate level of 6.6 mM-l. The patients received a mean of 21.7 litres intravenous fluids during the first 24 h to maintain a mean systolic blood pressure andgt;110 mm Hg and urine output of andgt;50 ml-h. Multiple metabolic and physiological parameters were obtained prospectively and on an almost hourly basis for the first 24 h after admission. Patients were followed throughout their stay in hospital to record outcome, complications, total hospital costs and length of stay. Results: Using regression and multivariate analysis, adult respiratory distress syndrome was correlated with hypothermia and persistent lactic acidosis (R2 =0.65, p = 0.005). Coagulopathy was associated with hypothermia (R2 = 0.43, p = 0.04). Length of stay and cost of hospitalisation were highly related to intensive care unit days, hospital-acquired infections and ventilator days (R2 = 0.86, p = 0.03). Conclusion: The initial 24 h events of trauma patients with haemorrhagic shock may have a significant impact on hospital costs and on complications developing later during hospitalisation.
dc.format.extent
dc.format.extent Pages: (340-343)
dc.language English
dc.publisher LONDON
dc.relation.ispartof Publication Name: Emergency Medicine Journal; Publication Year: 2009; Volume: 26; no. 5; Pages: (340-343);
dc.relation.ispartofseries
dc.relation.uri
dc.source Scopus
dc.subject.other
dc.title Relationship between intensive care complications and costs and initial 24 h events of trauma patients with severe haemorrhage
dc.type Article
dc.contributor.affiliation Husari, A.W., Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, American University of Beirut-Medical Center, Beirut, Lebanon, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, American University of Beirut-Medical Center, P O Box 113-6044, Beirut 1107 2802, Lebanon
dc.contributor.affiliation Belzberg, H., LAC+USC Medical Center, Los Angeles, CA, United States
dc.contributor.affiliation Kassak, K., Department of Health Management and Policy, American University of Beirut-Medical Center, Beirut, Lebanon
dc.contributor.affiliation Dunham, C.M., Trauma-Critical Care Services, St Elizabeth Health Center, Youngstown, OH, United States
dc.contributor.authorAddress Husari, A. W.; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, American University of Beirut-Medical Center, P O Box 113-6044, Beirut 1107 2802, Lebanon; email: ah51@aub.edu.lb
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Internal Medicine; Division: Pulmonary and Critical Care Medicine;
dc.contributor.authorDepartment Internal Medicine
dc.contributor.authorDivision Pulmonary and Critical Care Medicine
dc.contributor.authorEmail ah51@aub.edu.lb
dc.contributor.authorFaculty Faculty of Medicine
dc.contributor.authorInitials Husari, AW
dc.contributor.authorInitials Belzberg, H
dc.contributor.authorInitials Kassak, K
dc.contributor.authorInitials Dunham, CM
dc.contributor.authorOrcidID
dc.contributor.authorReprintAddress Husari, AW (reprint author), Amer Univ Beirut, Med Ctr, Dept Internal Med, Div Pulm and Crit Care Med, POB 113-6044, Beirut 11072802, Lebanon.
dc.contributor.authorResearcherID
dc.contributor.authorUniversity American University of Beirut Medical Center
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dc.description.citedCount 2
dc.description.citedTotWOSCount 2
dc.description.citedWOSCount 2
dc.format.extentCount 4
dc.identifier.articleNo
dc.identifier.coden EMJMB
dc.identifier.pubmedID 19386867
dc.identifier.scopusID 66849101985
dc.identifier.url
dc.publisher.address BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND
dc.relation.ispartofConference
dc.relation.ispartofConferenceCode
dc.relation.ispartofConferenceDate
dc.relation.ispartofConferenceHosting
dc.relation.ispartofConferenceLoc
dc.relation.ispartofConferenceSponsor
dc.relation.ispartofConferenceTitle
dc.relation.ispartofFundingAgency
dc.relation.ispartOfISOAbbr Emerg. Med. J.
dc.relation.ispartOfIssue 5
dc.relation.ispartOfPart
dc.relation.ispartofPubTitle Emergency Medicine Journal
dc.relation.ispartofPubTitleAbbr Emerg. Med. J.
dc.relation.ispartOfSpecialIssue
dc.relation.ispartOfSuppl
dc.relation.ispartOfVolume 26
dc.source.ID WOS:000265450100009
dc.type.publication Journal
dc.subject.otherAuthKeyword
dc.subject.otherChemCAS lactic acid, 113-21-3, 50-21-5
dc.subject.otherIndex lactic acid
dc.subject.otherIndex article
dc.subject.otherIndex bleeding
dc.subject.otherIndex blood clotting disorder
dc.subject.otherIndex clinical article
dc.subject.otherIndex controlled study
dc.subject.otherIndex disease association
dc.subject.otherIndex disease severity
dc.subject.otherIndex health care cost
dc.subject.otherIndex hemorrhagic shock
dc.subject.otherIndex human
dc.subject.otherIndex hypothermia
dc.subject.otherIndex hypovolemic shock
dc.subject.otherIndex injury
dc.subject.otherIndex intensive care
dc.subject.otherIndex lactic acidosis
dc.subject.otherIndex priority journal
dc.subject.otherIndex respiratory distress syndrome
dc.subject.otherIndex systolic blood pressure
dc.subject.otherIndex adult
dc.subject.otherIndex bleeding
dc.subject.otherIndex economics
dc.subject.otherIndex emergency health service
dc.subject.otherIndex health services research
dc.subject.otherIndex hospital cost
dc.subject.otherIndex injury
dc.subject.otherIndex intensive care
dc.subject.otherIndex length of stay
dc.subject.otherIndex methodology
dc.subject.otherIndex middle aged
dc.subject.otherIndex monitoring
dc.subject.otherIndex prognosis
dc.subject.otherIndex prospective study
dc.subject.otherIndex shock
dc.subject.otherIndex statistics
dc.subject.otherIndex time
dc.subject.otherIndex treatment outcome
dc.subject.otherIndex United States
dc.subject.otherIndex Adult
dc.subject.otherIndex Health Services Research
dc.subject.otherIndex Hemorrhage
dc.subject.otherIndex Hospital Costs
dc.subject.otherIndex Humans
dc.subject.otherIndex Intensive Care
dc.subject.otherIndex Length of Stay
dc.subject.otherIndex Maryland
dc.subject.otherIndex Middle Aged
dc.subject.otherIndex Monitoring, Physiologic
dc.subject.otherIndex Prognosis
dc.subject.otherIndex Prospective Studies
dc.subject.otherIndex Shock
dc.subject.otherIndex Time Factors
dc.subject.otherIndex Trauma Centers
dc.subject.otherIndex Treatment Outcome
dc.subject.otherIndex Wounds and Injuries
dc.subject.otherIndex Young Adult
dc.subject.otherKeywordPlus RESPIRATORY-DISTRESS-SYNDROME
dc.subject.otherKeywordPlus ACUTE LUNG INJURY
dc.subject.otherKeywordPlus NOSOCOMIAL INFECTION
dc.subject.otherKeywordPlus FLUID RESUSCITATION
dc.subject.otherKeywordPlus END-POINTS
dc.subject.otherKeywordPlus MASSIVE TRANSFUSION
dc.subject.otherKeywordPlus OUTCOME PREDICTION
dc.subject.otherKeywordPlus UNITED-STATES
dc.subject.otherKeywordPlus COAGULOPATHY
dc.subject.otherKeywordPlus HYPOTHERMIA
dc.subject.otherWOS Emergency Medicine


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