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Medical planning for disaster response: Identifying risk factors for developing adult respiratory distress syndrome among trauma patients

Ryan J. Keneally, MD, Mark C. Hubbard, MD, Katrina Hawkins, MD, Danielle Davison, MD, Jeffrey S. Berger, MD, MBA, FASA

Abstract


Introduction: Adult respiratory distress syndrome (ARDS) is a well-described complication of critical illness. We hypothesized that rates of comorbid diseases in a population may influence the risk for developing ARDS in trauma patients. This can help plan medical responses.

Methods: Patients from the 2017 National Trauma Databank were analyzed. Inclusion criteria were an injury severity score (ISS) of 2 and 1 or more documented days of mechanical ventilation. Data were analyzed using χ2, Student’s t test, Mann–Whitney U test, or logistic regression as indicated.

Results: Diabetes (odds ratio [OR] 1.33, 95 percent confidence interval [CI] 1.17-1.52), smoking (OR 1.26, 95 percent CI 1.13-1.40), transfusion (OR 1.20, 95 percent CI 1.09-1.32), ISS (OR 1.02, 95 percent CI 1.02-1.03), male gender (OR 1.22, 95 percent CI 1.10-1.35), decreasing Glasgow coma score (OR 1.04, 95 percent CI 1.03-1.05), and increasing abbreviated injury score of the thorax (OR 1.12, 95 percent CI 1.09-1.16) were associated with an increase in risk for developing ARDS.

Conclusion: Diabetes and smoking are risk factors for developing ARDS after trauma. Medical response planning in countries with high rates of diabetes mellitus or smoking should take into account a greater need for intensive care and longer patient admissions to field hospitals.


Keywords


ARDS, trauma, humanitarian response, diabetes, smoking

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References


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DOI: https://doi.org/10.5055/ajdm.2021.0385

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