ABSTRACT
PURPOSE: To identify high risk groups for infectious pulmonary complications (IPC) in patients with severe polytrauma, depending on the severity of the damage and the volume of acute blood loss in intensive care units in the early stages of the injury. MATERIAL AND METHODS: We studied 410 patients with severe polytrauma and IPC. Severity of injury was calculated according to ISS scale. ROC-curve was made in order to assess the prognostic significance of the impact of the severity of injury and the volume of acute blood loss on the development of IPC. RESULTS: To evaluate the effect of injury severity on the incidence of IPC, patients were divided into 2 groups: I--185 (ISS < 30) and group II--225 (ISS ≥ 30). In group I, prolonged mechanical ventilation was required in 4 patients (2.2%), pneumonia occurred in 9 patients (4.9%), no one died In group II--prolonged mechanical ventilation was performed in 120 (47.6%), pneumonia occurred in 158 (70.2%), sepsis--in 14 (6.2%), 37 (16.4%) patients died. Depending on the volume of blood loss into two groups: I group--179 patients (blood loss < 2000 ml) and group II--231 (blood loss ≥ 2000 ml). Prolonged mechanical ventilation was required 14 (7.6%) patients in group I and at 110 (47.6%)--II group, pneumonia developed in 14 (7.6%) and 153 (66.2%), respectively. Sepsis was developed in 14 patients of group II, whereas in patients of group I it was not registered also differed the number of deaths in the early period: in group 14 (2.2%) patients died, in II--33 (14.3%). CONCLUSIONS: Comparative statistical analysis revealed important criteriafor the prognosis of the IPC in patients with severe polytrauma: the severity of damage on a ISS ≥ 30 points and the volume of acute blood loss ≥ 2000 ml.
