Skip to main content
SpringerLink
Log in

Risk factors for sepsis in Korean trauma patients

  • Original Article
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Sepsis in severely injured patients is one of the leading causes of death in hospitals. The incidence of and risk factors for sepsis after trauma have been studied outside, but not within Korea. Therefore, this study investigated the incidence of sepsis and the independent risk factors for sepsis in moderately to severely injured patients in Korea.

Methods

The electronic medical records of patients who visited the emergency department from January 2010 to December 2012 were reviewed retrospectively. Patients older than 18 years of age with an Injury Severity Score (ISS) greater than or equal to nine points were included.

Results

A total of 183 patients met the study inclusion criteria. The median ISS was 14 (range 9–17) points and 15 (8 %) patients developed sepsis. The patients’ age [adjusted OR, 1.053; 95 % confidence intervals (CI), 1.015–1.094], ISS (adjusted OR, 1.114; 95 % CI, 1.046–1.187), and emergency surgery (adjusted OR, 3.727; 95 % CI, 1.051–13.221) were independent risk factors for post-traumatic sepsis.

Conclusions

Among the risk factors identified in the literature, our research confirmed only the patients’ age and ISS as risk factors for sepsis after trauma, and, additionally, identified emergency surgery as a risk factor in Korean patients. Therefore, trauma patients who have any of the risk factors mentioned above have a high risk of post-traumatic sepsis, which requires certain precautionary clinical measures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ruchholtz S, Lefering R, Paffrath T, Oestern HJ, Neugebauer E, Nast-Kolb D, Pape HC, Bouillon B. Reduction in mortality of severely injured patients in Germany. Dtsch Arztebl Int. 2008;105:225–31.

    PubMed  PubMed Central  Google Scholar 

  2. Probst C, Pape H-C, Hildebrand F, Regel G, Mahlke L, Giannoudis P, Krettek C, Grotz MR. 30 years of polytrauma care: an analysis of the change in strategies and results of 4849 cases treated at a single institution. Injury. 2009;40:77–83.

    Article  PubMed  Google Scholar 

  3. Kahl J, Calvo R, Sise M. The changing nature of death on the trauma service. J Trauma. 2013;75:195–201.

    Article  Google Scholar 

  4. Osborn TM, Tracy JK, Dunne JR, et al. Epidemiology of sepsis in patients with traumatic injury. Crit Care Med. 2004;32:2234–40.

    Article  PubMed  Google Scholar 

  5. Brattström O, Granath F, Rossi P, Oldner A. Early predictors of morbidity and mortality in trauma patients treated in the intensive care unit. Acta Anaesthesiol Scand. 2010;54:1007–17.

    Article  PubMed  Google Scholar 

  6. Beale E, Zhu J, Chan L, Shulman I, Harwood R, Demetriades D. Blood transfusion in critically injured patients: a prospective study. Injury. 2006;37:455–65.

    Article  PubMed  Google Scholar 

  7. Wafaisade A, Lefering R, Bouillon B, Sakka SG, Thamm OC, Paffrath T, Neugebauer E, Maegele M. Epidemiology and risk factors of sepsis after multiple trauma: an analysis of 29,829 patients from the Trauma Registry of the German Society for Trauma Surgery. Crit Care Med. 2011;39:621–8.

    Article  PubMed  Google Scholar 

  8. Bone RC. Let’s agree on terminology: definition of sepsis. Crit Care Med. 1991;19:973–6.

    Article  CAS  PubMed  Google Scholar 

  9. Annane D, Bellissant E, Cavaillon JM. Septic shock. Lancet. 2005;365:63–78.

    Article  CAS  PubMed  Google Scholar 

  10. Lenz A, Franklin GA, Cheadle WG. Systemic inflammation after trauma. Injury. 2007;38:1336–45.

    Article  PubMed  Google Scholar 

  11. Keel M, Trentz O. Pathophysiology of polytrauma. Injury. 2005;36:691–709.

    Article  PubMed  Google Scholar 

  12. Kisat M, Villegas C, Onguti S. Predictors of sepsis in moderately severely injured patients: an analysis of the national trauma data bank. Surg Infect. 2013;14:62–8.

    Article  Google Scholar 

  13. Muckart DJ, Bhagwangee S. American College of Chest Physicians/society of Critical Care Medicine Consensus Conference definitions of the systemic inflammatory response syndrome and allied disorders in relation to critically injured patients. Cri Care Med. 1997;25:1789–975.

    Article  CAS  Google Scholar 

  14. Giannoudis PV, Pape H-C, Smith RM. Immunity, trauma and the elderly. Injury. 2007;38:1401–4.

    Article  Google Scholar 

  15. Valente SA, Fallon WF, Alexander TS, Tomas ER, Evancho-Chapman MM, Schmidt SP, Gorski R, Pizov O, DeFine L, Clark AJ. Immunologic function in the elderly after injury-the neutrophil and innate immunity. J Trauma. 2009;67:968–74.

    Article  PubMed  Google Scholar 

  16. Hietbrink F, Koenderman L, Rijkers G, Leenen L. Trauma: the role of the innate immune system. World J Emerg Surg. 2006;1:15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Tschoeke SK, Ertel W. Immunoparalysis after multiple trauma. Injury. 2007;38:1346–57.

    Article  PubMed  Google Scholar 

  18. Tschoeke S, Hellmuth M, Hostmann A. The early second hit in trauma management augments the proinflammatory immune response to multiple injuries. J Trauma. 2007;62:1396–403.

    Article  PubMed  Google Scholar 

  19. Flohé S, Flohé SB, Schade FU, Waydhas C. Immune response of severely injured patients - influence of surgical intervention and therapeutic impact. Langenbecks Arch Surg. 2007;392:639–48.

    Article  PubMed  Google Scholar 

  20. Menger M, Vollmar B. Surgical trauma: hyperinflammation versus immunosuppression. Langenbeck’s Arch Surg. 2004;389:475–84.

    Article  Google Scholar 

  21. Angele MK, Chaudry IH. Surgical trauma and immunosuppression: pathophysiology and potential immunomodulatory approaches. Langenbecks Arch Surg. 2005;390:333–41.

    Article  PubMed  Google Scholar 

  22. Papia G, McLellan BA, El-Helou P, Louie M, Rachlis A, Szalai JP, Simor AE. Infection in hospitalized trauma patients: incidence, risk factors, and complications. J Trauma. 1999;47:923–7.

    Article  CAS  PubMed  Google Scholar 

  23. Moore FA, Moore EE, Sauaia A. Blood transfusion. An independent risk factor for postinjury multiple organ failure. Arch Surg. 1997;132:620–4.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was partially supported by a Korea University grant and Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education, Science and Technology (R1009985).

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Ansan Hospital, Korea University Medical Center, Ansan, Kyeonggido, Korea

    J.-H. Park & H.-J. Cho

  2. Department of Emergency Medicine, Guro Hospital, Korea University Medical Center, 148 Gurodong-ro, Guro-Gu, Seoul, 152-703, Korea

    S.-H. Choi, Y.-H. Yoon, S.-J. Park & J.-Y. Kim

Authors
  1. J.-H. Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S.-H. Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Y.-H. Yoon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S.-J. Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J.-Y. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. H.-J. Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S.-H. Choi.

Ethics declarations

The institutional review board for clinical research at Korea University Ansan Hospital approved the use of medical records for this retrospective study (No. AS14040).

Conflict of interest

Jong-Hak Park, Sung-Hyuk Choi, Young-Hoon Yoon, Sung-Jun Park, Jung-Youn Kim and Han-Jin Cho declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Park, JH., Choi, SH., Yoon, YH. et al. Risk factors for sepsis in Korean trauma patients. Eur J Trauma Emerg Surg 42, 453–458 (2016). https://doi.org/10.1007/s00068-015-0552-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-015-0552-6

Keywords

Search

Navigation