Analysis of clinical risk factors associated with mortality of severely injured multiple trauma patients with acute lung injury

Background lt is important to study the factors affectinq the clinical mortality of the severe multipIe trauma pOpuIatiOn.The present study was aimed to identify the potential risk factors that could】affect mortaIity rate of acute lung injury(ALI)in severely iniured multiple trauma population and to investiqate the effects of certain risk factOrs orl the prOqnOsis Ofdifferent patient subpopulations.Methods This is a follow-up study treating trauma as a single cause for emergency department(ED)and emergencyintensive care unit(EICU)admissions.Patients identified with severe multiple trauma with ea rlV Onset Of ALl wereenrolled from five trauma centers.Nineteen Dotential risk factors affectina the proqnosis of ALl were examined byunjvariate and multivariate Logistic regression analyses tO identify the ones that affected the mortality of these severemultiple trauma patients.Results There were 687 multipIe trauma patients with post-traumatic ALl admitted to ED and EICU during the Studyperiod.The six risk factors that affected the mortality with unadiusted odd ratios(ORs)and 95%confidence intervals(Cls)were Acute Physiology Score and Chronic Health Evaluation Score(APACHE)ll score,lnjury Severity Score(ISS),duration of trauma,age,aspiration of qastric contents,and disseminated intravascular coagulatiOR(DlC).Specific riskfactors also affected dIfferent patient subpopulations at different degrees(survivinq beyond 24 hours,72 hours,28 daysand with multiple blood transfusions and hiqher iniury scores).Conclusions Factors of APACHE ll Score,lSS and anpiration of qastric contents that could predict the mortalitv of ALlmay exist in the early stage of trauma.Duration of trauma and DIC that greatly affected and predicted the short-andlong-term development and mortallty of ALl deserve special attention.Elderly patients(aged beyond 65 years)were theindependent risk factOr for the secondary sepsis and deterioration of pulmonary function.Patients with these risk factorsneed aggressive supportive care as early as possibIe in order to prevent further aggravation.