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Defining Risk and Risk Factors for Unplanned ICU Admission of Trauma Patients.

Stephen E Ranney1, Tim H Lee1, Peter W Callas2

  • 1Department of Surgery, Larner College of Medicine & University of Vermont Medical Center, Burlington, Vermont.

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Unplanned ICU admissions in trauma patients are linked to specific injuries and health conditions. A new Risk Score (RS) can identify patients at higher risk, aiding in prevention strategies.

Keywords:
ICUQuality improvementTraumaTrauma patientsUnplanned ICU admissionUnplanned admission

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Area of Science:

  • Trauma surgery
  • Critical care medicine
  • Health informatics

Background:

  • Unplanned ICU admissions (up-ICUad) in trauma patients are associated with adverse outcomes.
  • Identifying patients at risk for up-ICUad is challenging.
  • Predictive tools are needed to manage trauma patient trajectories.

Purpose of the Study:

  • Identify injury patterns and comorbidities associated with up-ICUad.
  • Develop a predictive tool to identify trauma patients at risk for up-ICUad.
  • Improve patient outcomes by enabling proactive interventions.

Main Methods:

  • Retrospective study comparing trauma patients with and without up-ICUad.
  • Univariate and multivariate logistic regression analyses to identify risk factors.
  • Development and comparison of a Risk Score (RS) between groups.

Main Results:

  • 2.15% of 7206 trauma patients experienced up-ICUad.
  • Up-ICUad group was older, had longer hospital stays, and higher mortality.
  • Independent risk factors included age, specific comorbidities (CHF, COPD, PUD, liver disease, CKD), and injuries to thorax, spine, and lower extremities.

Conclusions:

  • Specific factors increase trauma patient risk for up-ICUad.
  • A calculable Risk Score (RS) can identify high-risk individuals.
  • This tool may aid in the prevention of unplanned ICU admissions.