Factors Predicting Intensive Care Unit Admission in Trauma Patients: A Multicenter Study Based on the National Trauma Registry of Iran

Mohammadreza  Golbakhsh; Seyed Aref  Danesh; Tina  Azimzadeh; Amirmohammad  Sharaf; Mehrdad  Sheikhvatan; Seyyed Hossein  Shafie

doi:10.18502/jost.v12i1.21123

Mohammadreza Golbakhsh Associate Professor, Department of Orthopedic Surgery, Orthopedic Subspecialty Research Center (OSRC), Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran
Seyed Aref Danesh Orthopedic Surgeon, Orthopedic Subspecialty Research Center (OSRC), Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran
Tina Azimzadeh Bachelor of Nursing, Orthopedic Subspecialty Research Center (OSRC), Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran
Amirmohammad Sharaf Medical Student, Orthopedic Subspecialty Research Center (OSRC), Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran
Mehrdad Sheikhvatan Assistant Professor, Department of Medical Genetics, Orthopedic Subspecialty Research Center (OSRC), Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran
Seyyed Hossein Shafie Assistant Professor, Department of Orthopedic Surgery, Orthopedic Subspecialty Research Center (OSRC), Sina University Hospit al, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jost.v12i1.21123

Keywords: Wounds and Injuries; Intensive Care Units; Emergency Hospital Service; Vital Signs; Risk Factors

Abstract

Background: Caring for trauma patients is a paramount international concern. Delays in diagnosing patients in need of intensive care have unredeemable consequences. Identifying predicting factors of intensive care unit (ICU) admission in trauma patients is not without merit regarding this matter. This study aimed to investigate the underlying factors associated with ICU admission in trauma patients.

Methods: A retrospective study was designed based on data from the National Trauma Registry of Iran (NTRI) from 2016 to 2021. ICU admission was considered the primary endpoint. Relationships between demographic variables, injury site, injury mechanism, vital signs, and trauma scores with the outcome were evaluated by univariate analyses. ICU risk factors and their specific odds ratio (OR) were determined by multivariate analysis.

Results: Following univariate and multivariate analyses, age > 55 years, widowhood, injuries due to road accidents, falling from a height, penetrating objects, and gunshot, underlying cardiovascular disease (CVD), injury to head, thorax, abdomen, spine, and lower extremities, hypotension, hypertension (HTN), tachycardia, bradycardia, hyperpnea, low oxygen saturation, high body temperature, Glasgow Coma Scale (GCS) ≤8, and Injury Severity Score (ISS) > 15 were introduced as independent risk factors of ICU admission. Nonetheless, transport to the hospital (personal car) and upper extremity injury reduced the outcome incidence.

Conclusion: Numerous contextual variables were significantly associated with ICU admission, each with its own matter. When entering the emergency room, paying attention to these factors can help diagnose people in need of ICU care sooner.