Factors predicting outcome in adult trauma patients admitted to a Tertiary ICU
Ndaku, Reabetswe Bardott
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Introduction: Trauma remains an important cause of mortality and morbidity in South Africa. In our centre, intensive care unit access is under severe strain. There is limited data specifically in our centre documenting the factors contributing to mortality and increased length of stay in ICU. Objectives: To elucidate the outcome (as measured by mortality and length of stay) of patients that are admitted to Intensive care unit following trauma. Method: A cross-sectional study dating from 2011 to 2015. Ethical clearance obtained from University of the Free State committee: HSREC 46/2016. Data analysed by means of SPSS 15.0 with frequencies and percentages and standard deviations. Stepwise logistic regression analysis was performed and the odds ratios, 95% CI and p-values calculated for risk factors. A p-value of < 0.05 was considered statistically significant. Results: The most prevalent mechanism of injury was assault (31%). Burns had the highest mortality rate (80%), primary orthopaedic patients had the longest length of stay recorded (128 days). Age was shown to be an independent predictor of outcome (p-value =0.016). Patients transferred from non-trauma centres did not have a statistically significant worse outcome (p-value = 0.58). Mortality rate of trauma patients admitted to ICU was 57.6%. Conclusions: There is an association between neurosurgical admissions and poorer outcome. No correlation between non-trauma centres transfer-ins and worse outcome was established; this is possibly an indicator of adequate resuscitation, stabilisation and effective referral systems in place. Our mortality rate is higher than that of international centres and this would need to be further studied.