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Incidence, impact and risk factors for multidrug-resistant organisms (MDRO) in patients with major trauma: a European Multicenter Cohort Study.
- Source :
- European Journal of Trauma & Emergency Surgery; Feb2022, Vol. 48 Issue 1, p659-665, 7p, 4 Charts
- Publication Year :
- 2022
-
Abstract
- Introduction: The burden of MDRO in health systems is a global issue, and a growing problem. We conducted a European multicenter cohort study to assess the incidence, impact and risk factors for multidrug-resistant organisms in patients with major trauma. We conducted this study because the predictive factors and effects of MDRO in severely injured patients are not yet described. Our hypothesis is that positive detection of MDRO in severely injured patients is associated with a less favorable outcome. Methods: Retrospective study of four level-1 trauma centers including all patients after major trauma with an injury severity score (ISS) ≥ 9 admitted to an intensive care unit (ICU) between 2013 and 2017. Outcome was measured using the Glasgow outcome scale (GOS). Results: Of 4131 included patients, 95 (2.3%) had a positive screening for MDRO. Risk factors for MDRO were male gender (OR 1.73 [95% CI 1.04–2.89]), ISS (OR 1.01 [95% CI 1.00–1.03]), PRBC's given (OR 1.73 [95% CI 1.09–2.78]), ICU stay > 48 h (OR 4.01 [95% CI 2.06–7.81]) and mechanical ventilation (OR 1.85 [95% CI 1.01–3.38]). A positive MDRO infection correlates with worse outcome. MDRO positive cases GOS: good recovery = 0.6%, moderate disability = 2.1%, severe disability = 5.6%, vegetative state = 5.7% (p < 0.001). Conclusions: MDRO in severely injured patients are rare but associated with a worse outcome at hospital discharge. We identified potential risk factors for MDRO in severely injured patients. Based on our results, we recommend a standardized screening procedure for major trauma patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- INJURY complications
RESEARCH
INTENSIVE care units
LENGTH of stay in hospitals
EVALUATION of medical care
CONFIDENCE intervals
TRAUMA centers
CONVALESCENCE
PATIENTS
RETROSPECTIVE studies
DISEASE incidence
DISABILITY evaluation
MEDICAL screening
RISK assessment
ARTIFICIAL respiration
PERSISTENT vegetative state
SEX distribution
MULTIDRUG resistance
EMERGENCY medical services
DESCRIPTIVE statistics
DRUG resistance in microorganisms
ODDS ratio
RED blood cell transfusion
LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 18639933
- Volume :
- 48
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- European Journal of Trauma & Emergency Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 155125304
- Full Text :
- https://doi.org/10.1007/s00068-020-01545-4