Korean J Thorac Cardiovasc Surg.  2017 Oct;50(5):346-354. 10.5090/kjtcs.2017.50.5.346.

Risk Factors for Pneumonia in Ventilated Trauma Patients with Multiple Rib Fractures

• Park HO
• Kang DH
• Moon SH
• Yang JH
• Kim SH
• Byun JH

• KMID: 2398390
• DOI: http://doi.org/10.5090/kjtcs.2017.50.5.346

Abstract

BACKGROUND
Ventilator-associated pneumonia (VAP) is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU). This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures.
METHODS
We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients. Trauma factors included sternal fracture, flail chest, diaphragm injury, traumatic aortic dissection, combined cardiac injury, pulmonary contusion, pneumothorax, hemothorax, hemopneumothorax, abbreviated injury scale score, thoracic trauma severity score, and injury severity score.
RESULTS
Forty-six patients (45.5%) had at least 1 episode of VAP, 10 (21.7%) of whom died in the ICU. Of the 55 (54.5%) patients who did not have pneumonia, 9 (16.4%) died in the ICU. Using logistic regression analysis, we found that VAP was associated with severe lung contusion (odds ratio, 3.07; 95% confidence interval, 1.12 to 8.39; p=0.029).
CONCLUSION
Severe pulmonary contusion (pulmonary lung contusion score 6-12) is an independent risk factor for VAP in ventilated trauma patients with multiple rib fractures.

Keyword

Ventilator-associated pneumonia; Thoracic injuries; Wounds and injuries; Injuries

MeSH Terms

Abbreviated Injury Scale
Contusions
Diaphragm
Flail Chest
Hemopneumothorax
Hemothorax
Humans
Injury Severity Score
Intensive Care Units
Logistic Models
Lung
Lung Injury
Mortality
Pneumonia*
Pneumonia, Ventilator-Associated
Pneumothorax
Retrospective Studies
Rib Fractures*
Ribs*
Risk Factors*
Thoracic Injuries
Wounds and Injuries