Risk Factors for Cytomegalovirus Gastrointestinal Disease in Patients with Trauma

This study investigated the clinical characteristics and risk factors for cytomegalovirus (CMV) gastrointestinal (GI) disease in patients with trauma using covariate matching.

This study included immunocompetent patients with trauma who had received a diagnosis of CMV GI disease between 2017 and 2022, confirmed by symptoms and quantitative real-time polymerase chain reaction. Patients were matched 3:1 on the basis of age, gender, mechanism of injury, Injury Severity Score, and Trauma and Injury Severity Score. Matched cases were compared using χ² or Fisher exact test and the Mann-Whitney U test. Significant variables identified during uni-variable analysis were entered into logistic regression.

A total of 23 patients received a diagnosis of CMV GI disease. After matching, 22 CMV-positive and 62 CMV-negative patients were analyzed. CMV-positive patients frequently underwent hollow viscus (HV) organ surgery (p = 0.028) and pre-peritoneal pelvic packing (PPP) (p = 0.012). The disease-positive group also exhibited a greater demand for mechanical ventilation, stress-dose steroids, renal replacement therapy (RRT) (all p < 0.001), and a greater blood product requirement within 24 h (p = 0.007). Logistic regression identified HV organ surgery (OR: 6.65, 95% confidence interval [CI]: 1.34-32.89, p = 0.020), PPP (OR: 12.58, 95% CI: 1.14-139.15, p = 0.039), stress-steroid use (OR: 8.31, 95% CI: 1.15-47.40, p = 0.017), and RRT (OR: 15.72, 95% CI: 3.02-81.81, p = 0.001) as risk factors for the disease.

This study identified HV organ surgery, PPP, steroid usage, and RRT as significant risk factors for CMV GI disease in patients with trauma.