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REVIEW OF TRAUMA ORTHOPAEDIC INTENSIVE CARE ADMISSION TO IDENTIFY HIGH RISK PATIENTS



Abstract

This study was undertaken to identify certain high-risk patient groups admitted following trauma, in an attempt to improve their management.

We retrospective reviewed 207 patients admitted to the ICU with orthopaedic injuries between 1997 and 2003, excluding from the study spinal patients, paediatric orthopaedic patients, and patients having elective surgery. The mean age of the patients was 36.7 years.

The mean duration of stay in the ICU was 8.4 days. In 32% of patients, the only injuries were orthopaedic, with 51% of this group having multiple fractures. Of the patients with associated injuries, 34% had chest injuries. Acute respiratory distress syndrome (ARDS) developed in 46 patients (22%), of whom 33 (71%) had more than one long bone fracture. The incidence of ARDS in patients with no associated injuries was 11%. The overall mortality rate was 13.5% (28 patients), and the mortality rate of patients with only orthopaedic injuries was 5% (10 patients). Death occurred on the day of admission in 28.5% and 70% of the deaths occurred after 8 days in the ICU. Overall, there was a 10% mortality rate in patients admitted to the ICU for more than a day.

We advise close observation of all orthopaedic patients with associated chest injuries and recommend appropriate fracture management within 8 days of admission.

Secretary: Dr H.J.S. Colyn, Editor: Professor M.B.E. Sweet. Correspondence should be addressed to SAOA, Box 47363, Parklands, Johannesburg, 2121, South Africa.