Epidemiology of severe trauma in Spain. Registry of trauma in the ICU (RETRAUCI). Pilot phase

Abstract

Objective To describe the characteristics and management of severe trauma disease in Spanish Intensive Care Units (ICUs). Registry of trauma in the ICU (RETRAUCI). Pilot phase. Design A prospective, multicenter registry. Setting Thirteen Spanish ICUs. Patients Patients with trauma disease admitted to the ICU. Interventions None. Main variables of interest Epidemiology, out-of-hospital attention, registry of injuries, resources utilization, complications and outcome were evaluated. Results Patients, n = 2242. Mean age 47.1 ± 19.02 years. Males 79%. Blunt trauma 93.9%. Injury Severity Score 22.2 ± 12.1, Revised Trauma Score 6.7 ± 1.6. Non-intentional in 84.4% of the cases. The most common causes of trauma were traffic accidents followed by pedestrian and high-energy falls. Up to 12.4% were taking antiplatelet medication or anticoagulants. Almost 28% had a suspected or confirmed toxic influence in trauma. Up to 31.5% required an out-of-hospital artificial airway. The time from trauma to ICU admission was 4.7 ± 5.3 hours. At ICU admission, 68.5% were hemodynamically stable. Brain and chest injuries predominated. A large number of complications were documented. Mechanical ventilation was used in 69.5% of the patients (mean 8.2 ± 9.9 days), of which 24.9% finally required a tracheostomy. The median duration of stay in the ICU and in hospital was 5 (range 3-13) and 9 (5-19) days, respectively. The ICU mortality rate was 12.3%, while the in-hospital mortality rate was 16.0%. Conclusions The pilot phase of the RETRAUCI offers a first impression of the epidemiology and management of trauma disease in Spanish ICUs.