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Arch Iran Med. 2021;24: 897-902.
doi: 10.34172/aim.2021.134
  Abstract View: 421
  PDF Download: 215

Original Article

Hazard Ratio of 90-Day Mortality in ICU Patients with Abdominal Injuries Compared with Head Injuries

Farshid Rahimi-Bashar 1 ORCID logo, Sara Ashtari 2 ORCID logo, Ali Fathi Jouzdani 3, Seyed Jalal Madani 4* ORCID logo, Keivan Gohari-Moghadam 5* ORCID logo

1 Department of Anesthesiology and Critical Care, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
2 Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
4 Trauma Research Center, Medicine Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
5 Medical ICU and Pulmonary Unit, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
*Corresponding Authors: *Corresponding Author: Seyed Jalal Madani, MD; Trauma Research Center, Medicine Faculty, Baqiyatallah University of Medical Sciences, P.O. Box 19575-174, Sheykh Bahayi Stress, Vanak Square, Tehran, Iran. Tel:+98-919-6017138; Fax:+98-21-8755487; Email: , Email: dr.jalalmadani@gmail.com; *Corresponding Author: Keivan Gohari-Moghadam, MD; Medical ICU and Pulmonary unit, Shariati hospital, Tehran University of Medical Sciences, P.O. Box 14117-13135, Jalal-e-Al-e-Ahmad Hwy, Tehran, Iran. Email: , Email: kgohari@tms.ac.ir

Abstract

Background: Despite advances in the treatment of abdominal injuries in patients with trauma, it remains a major public health problem worldwide. Evaluation of hazard ratio (HR) of 90-day mortality in intensive care unit (ICU) patients with abdominal injuries compare with head injuries in trauma patients and non-trauma surgical ICU patients.

Methods: This single-center, prospective cohort study was conducted on 400 patients admitted to the ICU between 2018 and 2019 due to trauma or surgery in Hamadan, Iran. The main outcome was mortality at 90-day after ICU admission. Cox proportional hazards models were used to determine the HR and 95% confidence interval (CI) for 90-day mortality.

Results: The 90-day mortality was 21.9% in abdominal injuries patients. According to multivariate Cox regression, the expected hazard mortality was 2.758 times higher in patients with abdominal injuries compared to non-trauma patients (HR: 2.758, 95% CI: 1.077–7.063, P=0.034). About more than 50% of all deaths in the abdominal and head trauma groups occurred within 20 days after admission. Mean time to death was 27.85±20.1, 30.27±18.22 and 31.43±26.24 days for abdominal-trauma, surgical-ICU, and head-trauma groups, respectively.

Conclusion: Difficulty in accurate diagnosis due to the complex physiological variability of abdominal trauma, less obvious clinical symptoms in blunt abdominal injuries, multi-organ dysfunction in abdominal injuries, failure to provide timely acute care, as well as different treatment methods all account for the high 90-day mortality rate in abdominal-trauma patients. Therefore, these patients need a multidisciplinary team to care for them both in the ICU and afterwards in the general ward.


Keywords: Abdominal trauma, Failure to rescue, Head trauma, Mortality

Cite this article as: Rahimi-Bashar F, Ashtari S, Fathi Jouzdani A, Madani SJ, Gohari-Moghadam K. Hazard ratio of 90-day mortality in icu patients with abdominal injuries compared with head injuries. Arch Iran Med. 2021;24(12):897-902. doi: 10.34172/aim.2021.134
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Submitted: 15 Jul 2021
Revision: 26 Jul 2021
Accepted: 01 Aug 2021
ePublished: 01 Dec 2021
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