Risk Factors And Prognosis Of Sepsis In Trauma Patients

Background and Purpose: Sepsis is a common complication and the main cause of death in trauma patients.Therefore,it is essential to identify the risk factors of sepsis after trauma and in-hospital death risk factors for trauma patients with sepsis.Methods: Data were extracted from the Medical Information Mart for Intensive Care database and divided into a training set and validation set.Then,risk factors were estimated using univariate and multivariate logistic regression analyses.Nomogram was created to predict the incidence of sepsis for trauma patients and in-hospital mortality for trauma patients with sepsis in intensive care units,respectively.And the accuracy of our nomogram was evaluated by drawing ROC curves.Results: A total of 744 patients were enrolled in the first part of our study,including 496 patients in the training set and 248 patients in the validation set.Logistic regression analysis showed that lactate,respiratory rate,ventilation,hematocrit,mean arterial pressure,vasopressor use and creatinine were independent risk factors for sepsis in trauma patients.The areas under the ROC curve of nomogram were0.7739 in the training set and 0.7057 in the validation set,showing promising predictive ability.In the second part,a total of 503 trauma patients with sepsis were enrolled,including 335 patients in the training set and 168 patients in the validation set.Logistic regression analysis revealed that age,respiratory rate,ventilation,partial thromboplastin time and vasopressor use were independent factors associated with in-hospital death.The areas under the ROC curve of nomogram were 0.8939 in the training set and 0.820 in the validation set,which showed better accuracy than the SOFA score,SAPS-Ⅱ score and APACHE-Ⅲ score,revealing strong predictive ability.Conclusion: Our nomogram could well predict the risk of sepsis for trauma patients and in-hospital death risk for trauma patients with sepsis in intensive care units.