Skip to main content

Main menu

  • Latest content
    • Latest content
  • Archive
  • About the journal
    • About the journal
    • Editorial board
    • Information for authors
    • FAQs
    • Thank you to our reviewers
    • The American Association for the Surgery of Trauma
  • Submit a paper
    • Online submission site
    • Information for authors
  • Email alerts
    • Email alerts
  • Help
    • Contact us
    • Feedback form
    • Reprints
    • Permissions
    • Advertising
  • BMJ Journals

User menu

  • Login

Search

  • Advanced search
  • BMJ Journals
  • Login
  • Facebook
  • Twitter
TSACO

Advanced Search

  • Latest content
    • Latest content
  • Archive
  • About the journal
    • About the journal
    • Editorial board
    • Information for authors
    • FAQs
    • Thank you to our reviewers
    • The American Association for the Surgery of Trauma
  • Submit a paper
    • Online submission site
    • Information for authors
  • Email alerts
    • Email alerts
  • Help
    • Contact us
    • Feedback form
    • Reprints
    • Permissions
    • Advertising
Open Access

Trauma ICU Prevalence Project: the diversity of surgical critical care

Christopher P Michetti, Samir M Fakhry, Karen Brasel, Niels D Martin, Erik J Teicher, Anna Newcomb
DOI: 10.1136/tsaco-2018-000288 Published 18 February 2019
Christopher P Michetti
1 Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Samir M Fakhry
2 Surgery, Reston Hospital Center, Reston, Virginia, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Karen Brasel
3 Surgery, Oregon Health and Science University, Portland, Oregon, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Niels D Martin
4 Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Niels D Martin
Erik J Teicher
1 Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anna Newcomb
1 Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF
Loading

Article Figures & Data

Tables

  • Table 1

    Hospital and ICU characteristics

    VariablesLevelsn/Median%/IQR
    Hospital size<250 beds24.08%
    250–499 beds1632.65%
    500–749 beds1836.73%
    750–999 beds714.29%
    ≥1000 beds612.24%
    State trauma center designationLevel 14591.84%
    Level 248.16%
    American College of Surgeons verifiedNo1020.41%
    Yes3979.59%
    Urban4897.95%
    Rural12.04%
    University2959.1%
    Non-university2040.8%
    Geographic locationNortheast1020.4%
    Southeast918.3%
    Midwest816.3%
    Southwest918.3%
    West1326.5%
    Adult ICU beds, n70(53–102)
    Pediatric ICU beds, n30(0–73)
    Total ICU beds, n105(64–181)
    Number of trauma patients evaluated as a formal ‘trauma activation’ per year<1000510.20%
    1000–19991530.61%
    2000–29991326.53%
    3000–3999510.20%
    ≥40001122.45%
    • ICU, intensive care unit.

  • Table 2

    Injury categories for trauma patients (n=665)

    Injuriesn%
    Rib fractures27741.65
    Brain25838.80
    Pneumothorax or hemothorax20530.83
    Facial fracture15823.76
    Cervical spine fracture13920.90
    Lung contusion13920.90
    Lower extremity long bone fracture12218.35
    Thoracic spine fracture10816.24
    Lumbar spine fracture8913.38
    Upper extremity long bone fracture8913.38
    Major vascular8813.23
    Liver8312.48
    Pelvic fracture—operative629.32
    Spleen588.72
    Spinal cord injury with neurological deficit558.27
    Stomach or small bowel558.27
    Pelvic fracture—non-operative548.12
    Kidney456.77
    Colon or rectum385.71
    Pancreas182.71
    • Categories are not mutually exclusive.

  • Table 3

    Classification of non-trauma surgical patients (n=536)

    Categoryn%
    Abdominal18434.33
    Neurological condition10018.66
    Other general surgery8014.93
    Vascular6011.19
    Cardiac336.16
    Plastics or oral-maxillofacial surgery183.36
    Transplant183.36
    Orthopedic152.80
    Thoracic152.80
    Burns or inhalation injury71.31
    Obstetrics, gynecology, gyn-oncology61.12
    • Categories are mutually exclusive.

  • Table 4

    Primary ICU admission diagnosis categories for non-trauma surgical patients (n=536)

    ICU admission diagnosisn%
    Respiratory19536.38
    Cardiovascular13925.93
    Infectious12823.88
    Gastrointestinal12723.69
    Neurological10619.78
    Monitoring8916.60
    Renal6311.75
    Metabolic509.33
    Hematological417.65
    Psychiatric30.56
    • Categories are not mutually exclusive.

    • ICU, intensive care unit.

  • Table 5

    ICU diagnoses for all patients (n=1416)

    Diagnosisn%
    Respiratory failure, tracheally intubated66847.18
    Acute anemia34824.58
    None32823.16
    Delirium22115.61
    Acute kidney injury (without filtration or dialysis)20414.41
    Sepsis19113.49
    Coma (Glasgow Coma Scale score <9)16911.94
    Arrhythmia requiring treatment107*11.69
    Pneumonia, ventilator associated (VAP)15911.23
    Septic shock14510.24
    Respiratory failure, not intubated966.78
    Acute kidney injury requiring hemofiltration or dialysis966.78
    Skin soft tissue infection946.64
    Hemorrhagic shock60*6.55
    Pneumonia, not ventilator associated (non-VAP)916.43
    Intra-abdominal infection52*5.68
    Multiple organ failure795.58
    Pressure ulceration, decubitus, or deep tissue injury674.73
    Adult respiratory distress syndrome624.38
    Other bleeding39*4.26
    Myocardial ischemia or infarction604.24
    Stroke574.03
    Urinary tract infection—catheter associated (CAUTI)563.95
    Deep vein thrombosis533.74
    Physical agitation requiring in-room supervision503.53
    Urinary tract infection (not CAUTI)382.68
    Pulmonary embolism382.68
    Upper gastrointestinal hemorrhage342.40
    Hypoxic/anoxic brain injury17*1.85
    Adrenal insufficiency treated with steroids15*1.63
    Central line-associated bloodstream infection231.62
    Clostridium difficile colitis211.48
    Lower gastrointestinal hemorrhage140.99
    ECMO used during this ICU stay70.49
    • Categories are not mutually exclusive.

    • *Prevalence calculated using only study day 2 patients, n=915.

    • ECMO, extracorporeal membrane oxygenation; ICU, intensive care unit.

  • Table 6

    Operations performed during the hospital stay on ICU patients

    OperationsAll (n=1416)*Trauma (n=665)Non-trauma (n=740)
    n (%)n (% trauma/% all)n (% non-trauma/% all)
    Any995 (70.2)460 (69.1/32.4)535 (72.2/37.7)
    None421 (29.7)205 (30.8/14.4)216 (29.1/15.2)
    Abdominal surgery336 (23.7)127 (19.0/8.9)209 (28.2/14.7)
    Other215 (15.2)94 (14.1/6.6)121 (16.3/8.5)
    Extremity bone, orthopedics168 (11.9)151 (22.7/10.6)17 (2.2/1.2)
    Soft tissue: injury, infection, fasciotomy126 (8.9)41 (6.1/2.8)85 (11.4/6.0)
    Spine112 (7.9)91 (13.6/6.4)21 (2.8/1.4)
    Craniotomy or craniectomy97 (6.9)64 (9.6/4.5)33 (4.4/2.3)
    Endovascular, including embolization66 (4.7)41 (6.1/2.8)25 (3.3/1.7)
    Vascular surgery: peripheral, extremities, neck64 (4.5)16 (2.4/1.1)48 (6.4/3.3)
    Thoracic surgery (non-cardiac, non-vascular)62 (4.4)42 (6.3/2.9)20 (2.7/1.4)
    Pelvic bone, orthopedics59 (4.2)56 (8.4/3.9)3 (0.4/0.2)
    Vascular surgery: aorta, central thoracic vessel43 (3.0)15 (2.2/1.0)28 (3.7/1.9)
    Facial bones35 (2.5)32 (4.8/2.2)3 (0.4/0.2)
    Cardiac34 (2.4)8 (1.2/0.5)26 (3.5/1.8)
    • Categories are not mutually exclusive.

    • *Includes 11 patients not categorized as trauma or non-trauma.

    • ICU, intensive care unit.

PreviousNext
Back to top
Email

Thank you for your interest in spreading the word on TSACO.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Trauma ICU Prevalence Project: the diversity of surgical critical care
(Your Name) has sent you a message from TSACO
(Your Name) thought you would like to see the TSACO web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Print
Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Trauma ICU Prevalence Project: the diversity of surgical critical care
Christopher P Michetti, Samir M Fakhry, Karen Brasel, Niels D Martin, Erik J Teicher, Anna Newcomb
Trauma Surg Acute Care Open Feb 2019, 4 (1) e000288; DOI: 10.1136/tsaco-2018-000288

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Cite This
  • APA
  • Chicago
  • Endnote
  • MLA
Loading
Trauma ICU Prevalence Project: the diversity of surgical critical care
Christopher P Michetti, Samir M Fakhry, Karen Brasel, Niels D Martin, Erik J Teicher, Anna Newcomb
Trauma Surg Acute Care Open Feb 2019, 4 (1) e000288; DOI: 10.1136/tsaco-2018-000288
Download PDF

Share
Trauma ICU Prevalence Project: the diversity of surgical critical care
Christopher P Michetti, Samir M Fakhry, Karen Brasel, Niels D Martin, Erik J Teicher, Anna Newcomb
Trauma Surgery & Acute Care Open Feb 2019, 4 (1) e000288; DOI: 10.1136/tsaco-2018-000288
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Respond to this article
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Article
    • Abstract
    • Background
    • Methods
    • Results
    • Discussion
    • Acknowledgments
    • Footnotes
    • References
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • Chronic critical illness after hypothermia in trauma patients
  • Quantitative analysis of intermuscular septa in the leg: implications for trauma surgery
  • Making your geriatric and palliative programs a strength: TQIP guideline implementation and the VRC perspective
Show more Plenary paper

Similar Articles

 
 

CONTENT

  • Latest content
  • Archive
  • eLetters
  • Sign up for email alerts
  • RSS

JOURNAL

  • About the journal
  • Editorial board
  • Thank you to our reviewers
  • The American Association for the Surgery of Trauma

AUTHORS

  • Information for authors
  • Submit a paper
  • Track your article
  • Open Access at BMJ

HELP

  • Contact us
  • Reprints
  • Permissions
  • Advertising
  • Feedback form

©Copyright 2023 The American Association for the Surgery of Trauma