Risk Factors for Pneumonia in Ventilated Trauma Patients with Multiple Rib Fractures.
10.5090/kjtcs.2017.50.5.346
- Author:
Hyun Oh PARK
1
;
Dong Hoon KANG
;
Seong Ho MOON
;
Jun Ho YANG
;
Sung Hwan KIM
;
Joung Hun BYUN
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Korea. jhunikr@naver.com
- Publication Type:Original Article
- Keywords:
Ventilator-associated pneumonia;
Thoracic injuries;
Wounds and injuries;
Injuries
- MeSH:
Abbreviated Injury Scale;
Contusions;
Diaphragm;
Flail Chest;
Hemopneumothorax;
Hemothorax;
Humans;
Injury Severity Score;
Intensive Care Units;
Logistic Models;
Lung;
Lung Injury;
Mortality;
Pneumonia*;
Pneumonia, Ventilator-Associated;
Pneumothorax;
Retrospective Studies;
Rib Fractures*;
Ribs*;
Risk Factors*;
Thoracic Injuries;
Wounds and Injuries
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2017;50(5):346-354
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU). This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. METHODS: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients. Trauma factors included sternal fracture, flail chest, diaphragm injury, traumatic aortic dissection, combined cardiac injury, pulmonary contusion, pneumothorax, hemothorax, hemopneumothorax, abbreviated injury scale score, thoracic trauma severity score, and injury severity score. RESULTS: Forty-six patients (45.5%) had at least 1 episode of VAP, 10 (21.7%) of whom died in the ICU. Of the 55 (54.5%) patients who did not have pneumonia, 9 (16.4%) died in the ICU. Using logistic regression analysis, we found that VAP was associated with severe lung contusion (odds ratio, 3.07; 95% confidence interval, 1.12 to 8.39; p=0.029). CONCLUSION: Severe pulmonary contusion (pulmonary lung contusion score 6–12) is an independent risk factor for VAP in ventilated trauma patients with multiple rib fractures.
