Evaluation of Pneumonia Risk Factors in Blunt Trauma Patients Followed in Intensive Care

INTRODUCTION: Injuries, leading to significant health and economic burdens globally, have become a prominent concern. Data from the World Health Organization (WHO) in 2012 ranks injuries as the ninth leading cause of death across all age groups, while the Centers for Disease Control and Prevention (CDC) highlights injuries as the primary cause of death among individuals under 45 years of age. Notably, traffic accidents, pedestrian incidents, and falls stand out as the leading causes of these injuries. In 2019, injuries resulted in staggering economic losses in the United States, with substantial portions allocated to hospital expenses, work loss, and the broader societal impact. This study addresses the increased susceptibility to pneumonia in trauma patients and the factors contributing to it, shedding light on its clinical implications.
METHODS: The study enrolled patients admitted to the Intensive Care Unit (ICU) following blunt trauma. Various statistical analyses were employed, including t-tests, Mann-Whitney U tests, chi-square tests, Fisher's exact tests, and Cox proportional hazards regression analysis, to identify potential risk factors for ventilator-associated pneumonia (VAP). The study examined variables associated with pneumonia in univariable and multivariate analyses, considering patient outcomes over time. Statistical significance was set at a p-value<0.05.
RESULTS: Over a five-year period, 32.3% of the patients (n: 42) developed pneumonia among the 130 included in the study. While pneumonia was more common in males and younger patients, no significant relationship was found with age or gender. The SAPS2 score was significantly higher in patients who developed pneumonia, but there was no significant relationship with the ISS score. Patients with pneumonia experienced significantly longer hospital stays, ICU stays, and mechanical ventilation durations. Notably, intubated patients, sedation, and nasogastric tube placement were significantly associated with pneumonia development.
DISCUSSION AND CONCLUSION: This study investigates risk factors for pneumonia development in trauma patients in the ICU and confirms the increased susceptibility of these patients to pneumonia. Although the study confirms factors like intubation, sedation, and nasogastric tube placement as risk factors, it provides nuanced insights into their impact on pneumonia development. Furthermore, the study highlights the importance of assessing pneumonia risk over time, emphasizing the critical role of early interventions to mitigate pneumonia rates. In conclusion, this study underscores the significance of identifying and understanding risk factors for pneumonia development in ICU patients after blunt trauma. Recognizing these factors and implementing preventive measures may ultimately reduce mortality and morbidity in this patient population.