Prognostic values of dynamical monitoring of early weight change in patients with severe trauma / 中华创伤杂志

ABSTRACT

Objective To investigate the association between body weight daily fluctuation and prognosis in severe trauma patients and evaluate the values of dynamical monitoring of early weight change in treatment of severe trauma.Methods A prospective cohort study was made on 65 patients with severe trauma treated between June 2015 and December 2015.There were 41 males and 24 females,with age of (54 ± 17)years.When admitted to the emergency intensive care unit (EICU),the patients were with body mass index (BMI) for (22.0 ±2.7) kg/m2,injury severity score (ISS) for (22 ±5) points,as well as acute physiology and chronic health evaluation (APACHE) Ⅱ for (15 ± 6)points.According to the survival status during hospitalization,the patients were distributed to death group (9 patients) and survival group (56 patients).Daily body weight was measured from admission by using a weighing scale to evaluate the difference of daily body weight change between two groups.The correlation between daily body weight change and volume change as well as the relationship between daily body weight change tendency and prognosis were evaluated.Results Overall,the variation of weight was negatively correlated with ICU stay in two groups.The weight variations in death group and survival group were 0.4 (0.2,0.8) kg and-0.2 (-0.7,0.2) kg,respectively (P ＜ 0.01).The cumulative weight variation between two groups within one week was 5.02 kg (95％ CI 3.97-6.07,P ＜0.01).The change of body weight was moderately correlated with corresponding fluid balance (r =0.69,P ＜ 0.01).According to the Logistic regression analysis,daily weight gain within one week was found to be positively associated with ICU mortality (OR =3.05,P ＜ 0.05).Conclusions The body weight is negatively correlated with ICU stay in severe trauma patients.The body weight change within one week in EICU is closely correlated with fluid balance and body weight increase may elevate the risk of ICU mortality.