The presence of the adult respiratory distress syndrome does not worsen mortality or discharge disability in blunt trauma patients with severe traumatic brain injury

Ali Salim, Matthew Martin, Carlos Brown, Kenji Inaba, Timothy Browder, Peter M Rhee, Pedro G R Teixeira, Demetrios Demetriades

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose: To evaluate the prevalence of the acute respiratory distress syndrome (ARDS) among blunt trauma patients with severe traumatic brain injury (TBI) and to determine if ARDS is associated with higher mortality, morbidity and worse discharge outcome. Methods: Blunt trauma patients with TBI (head abbreviated injury score {AIS} ≥ 4) who developed predefined ARDS criteria between January 2000 and December 2004 were prospectively collected as part of an ongoing ARDS database. Each patient in the TBI + ARDS group was matched with two control TBI patients based on age, injury severity score (ISS) and head AIS. Outcomes including complications, mortality and discharge disability were compared between the two groups. Results: Among 362 TBI patients, 28 (7.7%) developed ARDS. There were no differences between the two groups with respect to age, sex, ISS, Glasgow coma score (GCS), head, abdomen and extremity AIS. The TBI + ARDS group had significantly more patients with chest AIS ≥ 3 (57.1% versus 32.1%, p = 0.03). There was no difference with respect to overall mortality between the TBI + ARDS group (50.0%) and the TBI group (51.8%) (OR 0.79: 95% CI 0.31-2.03, p = 0.63). There was no significant difference with respect to discharge functional capacity between the two groups. There were significantly more overall complications in the TBI + ARDS group (42.9%) compared to the TBI group (16.1%) (OR 3.66: 95% CI 1.19-11.24, p = 0.02). The TBI + ARDS group had an overall mean intensive care unit (ICU) length of stay of 15.6 days, versus 8.4 days in the TBI group (p < 0.01). The TBI + ARDS group had significantly higher hospital charges than the TBI group ($210,097 versus $115,342, p < 0.01). Conclusion: The presence of ARDS was not associated with higher mortality or worse discharge disability. It was, however, associated with higher hospital morbidity, longer ICU and hospital length of stay.

Original languageEnglish (US)
Pages (from-to)30-35
Number of pages6
JournalInjury
Volume39
Issue number1
DOIs
StatePublished - Jan 2008
Externally publishedYes

Fingerprint

Adult Respiratory Distress Syndrome
Mortality
Wounds and Injuries
Length of Stay
Injury Severity Score
Traumatic Brain Injury
Craniocerebral Trauma
Intensive Care Units
Morbidity
Hospital Charges
Thoracic Injuries
Coma
Abdomen
Research Design
Extremities

Keywords

  • Adult respiratory distress syndrome
  • Disability
  • Morbidity
  • Mortality
  • Trauma
  • Traumatic brain injury

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine

Cite this

The presence of the adult respiratory distress syndrome does not worsen mortality or discharge disability in blunt trauma patients with severe traumatic brain injury. / Salim, Ali; Martin, Matthew; Brown, Carlos; Inaba, Kenji; Browder, Timothy; Rhee, Peter M; Teixeira, Pedro G R; Demetriades, Demetrios.

In: Injury, Vol. 39, No. 1, 01.2008, p. 30-35.

Research output: Contribution to journalArticle

Salim, Ali ; Martin, Matthew ; Brown, Carlos ; Inaba, Kenji ; Browder, Timothy ; Rhee, Peter M ; Teixeira, Pedro G R ; Demetriades, Demetrios. / The presence of the adult respiratory distress syndrome does not worsen mortality or discharge disability in blunt trauma patients with severe traumatic brain injury. In: Injury. 2008 ; Vol. 39, No. 1. pp. 30-35.
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T1 - The presence of the adult respiratory distress syndrome does not worsen mortality or discharge disability in blunt trauma patients with severe traumatic brain injury

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AU - Martin, Matthew

AU - Brown, Carlos

AU - Inaba, Kenji

AU - Browder, Timothy

AU - Rhee, Peter M

AU - Teixeira, Pedro G R

AU - Demetriades, Demetrios

PY - 2008/1

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N2 - Purpose: To evaluate the prevalence of the acute respiratory distress syndrome (ARDS) among blunt trauma patients with severe traumatic brain injury (TBI) and to determine if ARDS is associated with higher mortality, morbidity and worse discharge outcome. Methods: Blunt trauma patients with TBI (head abbreviated injury score {AIS} ≥ 4) who developed predefined ARDS criteria between January 2000 and December 2004 were prospectively collected as part of an ongoing ARDS database. Each patient in the TBI + ARDS group was matched with two control TBI patients based on age, injury severity score (ISS) and head AIS. Outcomes including complications, mortality and discharge disability were compared between the two groups. Results: Among 362 TBI patients, 28 (7.7%) developed ARDS. There were no differences between the two groups with respect to age, sex, ISS, Glasgow coma score (GCS), head, abdomen and extremity AIS. The TBI + ARDS group had significantly more patients with chest AIS ≥ 3 (57.1% versus 32.1%, p = 0.03). There was no difference with respect to overall mortality between the TBI + ARDS group (50.0%) and the TBI group (51.8%) (OR 0.79: 95% CI 0.31-2.03, p = 0.63). There was no significant difference with respect to discharge functional capacity between the two groups. There were significantly more overall complications in the TBI + ARDS group (42.9%) compared to the TBI group (16.1%) (OR 3.66: 95% CI 1.19-11.24, p = 0.02). The TBI + ARDS group had an overall mean intensive care unit (ICU) length of stay of 15.6 days, versus 8.4 days in the TBI group (p < 0.01). The TBI + ARDS group had significantly higher hospital charges than the TBI group ($210,097 versus $115,342, p < 0.01). Conclusion: The presence of ARDS was not associated with higher mortality or worse discharge disability. It was, however, associated with higher hospital morbidity, longer ICU and hospital length of stay.

AB - Purpose: To evaluate the prevalence of the acute respiratory distress syndrome (ARDS) among blunt trauma patients with severe traumatic brain injury (TBI) and to determine if ARDS is associated with higher mortality, morbidity and worse discharge outcome. Methods: Blunt trauma patients with TBI (head abbreviated injury score {AIS} ≥ 4) who developed predefined ARDS criteria between January 2000 and December 2004 were prospectively collected as part of an ongoing ARDS database. Each patient in the TBI + ARDS group was matched with two control TBI patients based on age, injury severity score (ISS) and head AIS. Outcomes including complications, mortality and discharge disability were compared between the two groups. Results: Among 362 TBI patients, 28 (7.7%) developed ARDS. There were no differences between the two groups with respect to age, sex, ISS, Glasgow coma score (GCS), head, abdomen and extremity AIS. The TBI + ARDS group had significantly more patients with chest AIS ≥ 3 (57.1% versus 32.1%, p = 0.03). There was no difference with respect to overall mortality between the TBI + ARDS group (50.0%) and the TBI group (51.8%) (OR 0.79: 95% CI 0.31-2.03, p = 0.63). There was no significant difference with respect to discharge functional capacity between the two groups. There were significantly more overall complications in the TBI + ARDS group (42.9%) compared to the TBI group (16.1%) (OR 3.66: 95% CI 1.19-11.24, p = 0.02). The TBI + ARDS group had an overall mean intensive care unit (ICU) length of stay of 15.6 days, versus 8.4 days in the TBI group (p < 0.01). The TBI + ARDS group had significantly higher hospital charges than the TBI group ($210,097 versus $115,342, p < 0.01). Conclusion: The presence of ARDS was not associated with higher mortality or worse discharge disability. It was, however, associated with higher hospital morbidity, longer ICU and hospital length of stay.

KW - Adult respiratory distress syndrome

KW - Disability

KW - Morbidity

KW - Mortality

KW - Trauma

KW - Traumatic brain injury

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