Epidemiologic Patterns of Bacteremia After Trauma

Epidemiological Patterns for Early Onset and Late Onset Bacteremia After Trauma

Presence of pelvic and liver injury on arrival in ED, gastrointestinal tract perforation and massive transfusion within the first 24 hours after trauma appear a significant risk factor for bacteremia. Scoring with the ISS, intra-abdominal and pelvic injury and presence of transfusion and shock at admission to ED appears a useful tool for identifying trauma patients at increased risk of bacteremia.

Study Overview

• Status: Completed
• Conditions: Bacteremia

Detailed Description

Purpose: Bacteremia is a major nosocomial infection problem in view of its high mortality. Bacteremia occurs in trauma patients frequently and increases a morbidity and mortality. The aim of this study was to identify risk factors and to describe epidemiological patterns for early onset (EOB) and late onset (LOB) bacteremia after trauma.

Methods: All trauma patients admitted to surgical intensive care unit (SICU) and general ward (GW) from January 2011 to December 2015 were retrospectively enrolled. The following information was collected for each patient and recorded in a computer database: demography, severity of trauma according to the Injury Severity Score (ISS) and each abbreviated injury score (AIS), severity of coma according to the Glasgow Coma Scale (GCS), presence of shock and transfusion. Early onset bacteremia was defined as EOB when onset occurred within 7 days after trauma, and late onset bacteremia was defined as LOB when appearing after 7 days from trauma.

• Study Type: Observational
• Enrollment (Actual): 859

Contacts and Locations

Study Locations

• Korea, Republic of
  • Seoul, Korea, Republic of
    • Hakjae Lee

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients admitted to Asan Medical Center with trauma from January 2011 to December 2015

Description

Inclusion Criteria:

• The patients who admitted to intensive care unit (ICU) or general ward (GW) through the emergency department after trauma were studied

Exclusion Criteria:

• Patients who arrived on dead-on arrival

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
1; Patients with Bacteremia after trauma
2; Patients with non-bacteremia after trauma

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Risk factor for bacteremia after trauma	finding fisk factor for bacteremia in traumatic patients	5 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Etiology of bacteremia after trauma	distinguishing G(+) cocci, G(-) rod, and candida spp.	5 years

Collaborators and Investigators

• Sponsor: Asan Medical Center

Publications and helpful links

General Publications

• Rello J, Ricart M, Mirelis B, Quintana E, Gurgui M, Net A, Prats G. Nosocomial bacteremia in a medical-surgical intensive care unit: epidemiologic characteristics and factors influencing mortality in 111 episodes. Intensive Care Med. 1994;20(2):94-8. doi: 10.1007/BF01707661.
• Antonelli M, Moro ML, D'Errico RR, Conti G, Bufi M, Gasparetto A. Early and late onset bacteremia have different risk factors in trauma patients. Intensive Care Med. 1996 Aug;22(8):735-41. doi: 10.1007/BF01709514.
• Menges P, Kessler W, Kloecker C, Feuerherd M, Gaubert S, Diedrich S, van der Linde J, Hegenbart A, Busemann A, Traeger T, Cziupka K, Heidecke CD, Maier S. Surgical trauma and postoperative immune dysfunction. Eur Surg Res. 2012;48(4):180-6. doi: 10.1159/000338196. Epub 2012 May 25.
• Niven DJ, Fick GH, Kirkpatrick AW, Grant V, Laupland KB. Cost and outcomes of nosocomial bloodstream infections complicating major traumatic injury. J Hosp Infect. 2010 Dec;76(4):296-9. doi: 10.1016/j.jhin.2010.06.004. Epub 2010 Aug 11.

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2011
• Primary Completion (Actual): December 31, 2015
• Study Completion (Actual): December 31, 2018

Study Registration Dates

• First Submitted: July 31, 2019
• First Submitted That Met QC Criteria: July 31, 2019
• First Posted (Actual): August 2, 2019

Study Record Updates

• Last Update Posted (Actual): August 2, 2019
• Last Update Submitted That Met QC Criteria: July 31, 2019
• Last Verified: July 1, 2019

More Information

Terms related to this study

• Keywords: trauma; CLABSI
• Additional Relevant MeSH Terms: Pathologic Processes; Infections; Systemic Inflammatory Response Syndrome; Inflammation; Bacterial Infections; Bacterial Infections and Mycoses; Sepsis; Bacteremia
• Other Study ID Numbers: AsanMC-Bacteremia

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No