Ultra-Early Infection and High Death Risk of Sepsis in ICU Patients with Traumatic Brain Injure

Wang Guang-Sheng1, Zhou Ye-Ting2, Wang Shao-Dan3, Zhei Xiao-Lei4, Wang Yuan-Wei1, Wang Ying1, Zhou Jin-Jin1, and Tong Dao-Ming1*

1Department of Neurology, Affiliated Shuyang Hospital, Xuzhou Medical University, China
2Department of Surgery, Affiliated Shuyang Hospital, Xuzhou Medical University, China
3Department of Intensive Care Medicine, Affiliated Shuyang Hospital, Xuzhou Medical University, China
4Department of Neurosurgery, Affiliated Shuyang Hospital, Xuzhou Medical University, China

^*Correspondance to: Tong Dao-Ming 

 PDF  Full Text DOI: 10.25107/2474-1647.3375

Abstract

Background: There are few previous reports of ultra-early predicting infection and sepsis after Traumatic Brain Injury (TBI). This study is to assess ultra-early infection and death risk of sepsis following TBI. Methods: We retrospectively enrolled TBI patients with first 3 h interval from trauma in an ICU of China (from January 2015 to December 2017). We used the SIRS criteria to screen infection, and used SOFA criteria to identify sepsis after TBI. An outcome measure mainly was mortality at first 48 h. Results: A total of 263 TBI patients were included in our study. Among 152 (57.8%) ultra-early infected person, the time of trauma to infection onset was in 1 h (median, range, 0.5-3). Among 118 (44.9%) sepsis within initial 48 h after trauma, the time of median from trauma to sepsis was 10.0 h (range, 1-48). Mortality of sepsis in TBI at initial 48 h was in 67.6%. Cox regression demonstrated that lower GCS score (OR, 0.8; 95% CI, 0.729-0.865), higher SOFA score (OR, 1.1; 95% CI, 1.041- 1.151), less ICU days (OR, 0.8; 95% CI, 0.729-0.832), requiring mechanical ventilation (OR, 2.1; 95% CI, 1.332-3.593), and unused antibiotics in initial 3 h (OR, 2.3; 95% CI, 1.213-3.772) were related to the risk of early death in TBI with sepsis. Conclusion: Sepsis was 44.9% of TBI patients, with high mortality at initial 48 h, suggesting that TBI patients with ultra-early infection have to be used antibiotics within initial 0.5 h to 1 h in the ICU.

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Cite the article

Guang-Sheng W, Ye-Ting Z, Shao- Dan W, Xiao-Lei Z, Yuan-Wei W, Ying Wang, et al. Ultra-Early Infection and High Death Risk of Sepsis in ICU Patients with Traumatic Brain Injure. Clin Surg. 2021; 6: 3375..