M. Duverseau1,2, D. Suma1,2, R. Patel2, S. Galvin1, A. Conquest2, M. Schurr1,2 1Mountain Area Health Education Center,Asheville, NORTH CAROLINA, USA 2Mission Hospitals,Asheville, NORTH CAROLINA, USA
Introduction: Intensive care unit beds are in demand in large regional referral hospitals; therefore, non-intubated poly-trauma patients are often admitted to general care (GC) wards. We hypothesized that trauma patients with ISS≥15 and unexpected intensive care unit admission (U-ICU) after initial admission to GC had increased morbidity and mortality. We also hypothesized that those requiring U-ICU could be predicted based on admission parameters.
Methods: This was a retrospective review of patients ≥18 years old, admitted to GC with blunt trauma and ISS≥15 from April 2015-March 2017. Demographics were collected along with injury patterns and complications. Statistics included Chi square, Fisher’s exact, Mann-Whitney, and t-tests.
Results: 502/986 (50.9%) were directly admitted to GC. Prevalence of U-ICU was 9.8% (49/502 patients). The only admission predictor of U-ICU was history of myocardial infarction (8/49, 16.3%, vs 21/453, 4.6%, P<.001). Outcomes in table 1.
Conclusion: Half of all severely injured patients can be managed on GC ward; however 9.8% of patients will require U-ICU admission. Admission history of myocardial infarction predicts those at risk. Severely injured patients with U-ICU admission have significant cardiopulmonary complications, but can be rescued with no increase in overall mortality.
