OBJECTIVE: To investigate incidence, risk factors and outcome of Acinetobacter baumanii infection in trauma patients. DESIGN AND SETTING: A retrospective analysis of prospectively collected data of all trauma patients admitted to a general intensive care unit (ICU) of a 1,500-bed university hospital over 3 years. PATIENTS: Three hundred thirty trauma patients were included in the study. RESULTS: Thirty-six (10.9%) cases of A. baumanii infection were observed; 29 of them were late onset pneumonia. Patients with A. baumanii infection had a significantly higher Injury Severity Score (ISS) (p = 0.02), a lower Glasgow Coma Scale (GCS) on ICU admission (p = 0.03), stayed longer in the ICU (p = 0.00001), were mechanically ventilated for a longer period of time (p = 0.00001), were more frequently admitted to the emergency department with hypotension (p = 0.02), and had trans-skeletal traction for more than 3 days (p = 0.003) in comparison to the 294 patients who did not develop A. baumanii infection. At multivariate analysis the time spent on mechanical ventilation (p = 0.02) and the presence of long-term trans-skeletal traction (p = 0.04) were the only independent risk factors for A. baumanii infection. Patients with A. baumanii infection had a high mortality rate (9 out of 36; 25.0%). ISS (p = 0.003), GCS (p = 0.001) and older age (p = 0.00001), but not A. baumanii infection (p = 0.15), were independently correlated with mortality. CONCLUSIONS: In trauma patients prolonged mechanical ventilation and delayed fracture fixation with the persistence of trans-skeletal traction were major risk factors for A. baumanii infection. The presence of this infection was not correlated with mortality.

Antonelli, M., Caricato, A., Montini, L., Bello, G., Michetti, V., Maviglia, R., Bocci, M. G., Mercurio, G., Maggiore, S. M., Risk factors and outcome of Acinetobacter baumanii infection in severe trauma patients., <<INTENSIVE CARE MEDICINE>>, 2009; 2009 (Novembre): 1964-1969 [http://hdl.handle.net/10807/72545]

Risk factors and outcome of Acinetobacter baumanii infection in severe trauma patients.

Antonelli, Massimo;Caricato, Anselmo;Montini, Luca;Bello, Giuseppe;Michetti, Vincenzo;Maviglia, Riccardo;Bocci, Maria Grazia;Mercurio, Giovanna;Maggiore, Salvatore Maurizio
2009

Abstract

OBJECTIVE: To investigate incidence, risk factors and outcome of Acinetobacter baumanii infection in trauma patients. DESIGN AND SETTING: A retrospective analysis of prospectively collected data of all trauma patients admitted to a general intensive care unit (ICU) of a 1,500-bed university hospital over 3 years. PATIENTS: Three hundred thirty trauma patients were included in the study. RESULTS: Thirty-six (10.9%) cases of A. baumanii infection were observed; 29 of them were late onset pneumonia. Patients with A. baumanii infection had a significantly higher Injury Severity Score (ISS) (p = 0.02), a lower Glasgow Coma Scale (GCS) on ICU admission (p = 0.03), stayed longer in the ICU (p = 0.00001), were mechanically ventilated for a longer period of time (p = 0.00001), were more frequently admitted to the emergency department with hypotension (p = 0.02), and had trans-skeletal traction for more than 3 days (p = 0.003) in comparison to the 294 patients who did not develop A. baumanii infection. At multivariate analysis the time spent on mechanical ventilation (p = 0.02) and the presence of long-term trans-skeletal traction (p = 0.04) were the only independent risk factors for A. baumanii infection. Patients with A. baumanii infection had a high mortality rate (9 out of 36; 25.0%). ISS (p = 0.003), GCS (p = 0.001) and older age (p = 0.00001), but not A. baumanii infection (p = 0.15), were independently correlated with mortality. CONCLUSIONS: In trauma patients prolonged mechanical ventilation and delayed fracture fixation with the persistence of trans-skeletal traction were major risk factors for A. baumanii infection. The presence of this infection was not correlated with mortality.
Inglese
Antonelli, M., Caricato, A., Montini, L., Bello, G., Michetti, V., Maviglia, R., Bocci, M. G., Mercurio, G., Maggiore, S. M., Risk factors and outcome of Acinetobacter baumanii infection in severe trauma patients., <>, 2009; 2009 (Novembre): 1964-1969 [http://hdl.handle.net/10807/72545]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/72545
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