Trauma ICU Prevalence Project: the diversity of surgical critical care

Article Figures & Data

Table 1

Hospital and ICU characteristics

Variables	Levels	n/Median	%/IQR
Hospital size	<250 beds	2	4.08%
	250–499 beds	16	32.65%
	500–749 beds	18	36.73%
	750–999 beds	7	14.29%
	≥1000 beds	6	12.24%
State trauma center designation	Level 1	45	91.84%
	Level 2	4	8.16%
American College of Surgeons verified	No	10	20.41%
	Yes	39	79.59%
Urban		48	97.95%
Rural		1	2.04%
University		29	59.1%
Non-university		20	40.8%
Geographic location	Northeast	10	20.4%
	Southeast	9	18.3%
	Midwest	8	16.3%
	Southwest	9	18.3%
	West	13	26.5%
Adult ICU beds, n		70	(53–102)
Pediatric ICU beds, n		30	(0–73)
Total ICU beds, n		105	(64–181)
Number of trauma patients evaluated as a formal ‘trauma activation’ per year	<1000	5	10.20%
	1000–1999	15	30.61%
	2000–2999	13	26.53%
	3000–3999	5	10.20%
	≥4000	11	22.45%

Table 2

Injury categories for trauma patients (n=665)

Injuries	n	%
Rib fractures	277	41.65
Brain	258	38.80
Pneumothorax or hemothorax	205	30.83
Facial fracture	158	23.76
Cervical spine fracture	139	20.90
Lung contusion	139	20.90
Lower extremity long bone fracture	122	18.35
Thoracic spine fracture	108	16.24
Lumbar spine fracture	89	13.38
Upper extremity long bone fracture	89	13.38
Major vascular	88	13.23
Liver	83	12.48
Pelvic fracture—operative	62	9.32
Spleen	58	8.72
Spinal cord injury with neurological deficit	55	8.27
Stomach or small bowel	55	8.27
Pelvic fracture—non-operative	54	8.12
Kidney	45	6.77
Colon or rectum	38	5.71
Pancreas	18	2.71

Table 3

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

Category	n	%
Abdominal	184	34.33
Neurological condition	100	18.66
Other general surgery	80	14.93
Vascular	60	11.19
Cardiac	33	6.16
Plastics or oral-maxillofacial surgery	18	3.36
Transplant	18	3.36
Orthopedic	15	2.80
Thoracic	15	2.80
Burns or inhalation injury	7	1.31
Obstetrics, gynecology, gyn-oncology	6	1.12

Table 4

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

Table 5

ICU diagnoses for all patients (n=1416)

Diagnosis	n	%
Respiratory failure, tracheally intubated	668	47.18
Acute anemia	348	24.58
None	328	23.16
Delirium	221	15.61
Acute kidney injury (without filtration or dialysis)	204	14.41
Sepsis	191	13.49
Coma (Glasgow Coma Scale score <9)	169	11.94
Arrhythmia requiring treatment	107*	11.69
Pneumonia, ventilator associated (VAP)	159	11.23
Septic shock	145	10.24
Respiratory failure, not intubated	96	6.78
Acute kidney injury requiring hemofiltration or dialysis	96	6.78
Skin soft tissue infection	94	6.64
Hemorrhagic shock	60*	6.55
Pneumonia, not ventilator associated (non-VAP)	91	6.43
Intra-abdominal infection	52*	5.68
Multiple organ failure	79	5.58
Pressure ulceration, decubitus, or deep tissue injury	67	4.73
Adult respiratory distress syndrome	62	4.38
Other bleeding	39*	4.26
Myocardial ischemia or infarction	60	4.24
Stroke	57	4.03
Urinary tract infection—catheter associated (CAUTI)	56	3.95
Deep vein thrombosis	53	3.74
Physical agitation requiring in-room supervision	50	3.53
Urinary tract infection (not CAUTI)	38	2.68
Pulmonary embolism	38	2.68
Upper gastrointestinal hemorrhage	34	2.40
Hypoxic/anoxic brain injury	17*	1.85
Adrenal insufficiency treated with steroids	15*	1.63
Central line-associated bloodstream infection	23	1.62
Clostridium difficile colitis	21	1.48
Lower gastrointestinal hemorrhage	14	0.99
ECMO used during this ICU stay	7	0.49

Table 6

Operations performed during the hospital stay on ICU patients

Operations	All (n=1416)*	Trauma (n=665)	Non-trauma (n=740)
Operations	n (%)	n (% trauma/% all)	n (% non-trauma/% all)
Any	995 (70.2)	460 (69.1/32.4)	535 (72.2/37.7)
None	421 (29.7)	205 (30.8/14.4)	216 (29.1/15.2)
Abdominal surgery	336 (23.7)	127 (19.0/8.9)	209 (28.2/14.7)
Other	215 (15.2)	94 (14.1/6.6)	121 (16.3/8.5)
Extremity bone, orthopedics	168 (11.9)	151 (22.7/10.6)	17 (2.2/1.2)
Soft tissue: injury, infection, fasciotomy	126 (8.9)	41 (6.1/2.8)	85 (11.4/6.0)
Spine	112 (7.9)	91 (13.6/6.4)	21 (2.8/1.4)
Craniotomy or craniectomy	97 (6.9)	64 (9.6/4.5)	33 (4.4/2.3)
Endovascular, including embolization	66 (4.7)	41 (6.1/2.8)	25 (3.3/1.7)
Vascular surgery: peripheral, extremities, neck	64 (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, orthopedics	59 (4.2)	56 (8.4/3.9)	3 (0.4/0.2)
Vascular surgery: aorta, central thoracic vessel	43 (3.0)	15 (2.2/1.0)	28 (3.7/1.9)
Facial bones	35 (2.5)	32 (4.8/2.2)	3 (0.4/0.2)
Cardiac	34 (2.4)	8 (1.2/0.5)	26 (3.5/1.8)