Outcome after Hemorrhagic Shock in Trauma Patients

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Abstract
It is essential to identify patients at high risk of death and complications for future studies of interventions to decrease reperfusion injury. We conducted an inception cohort study at a Level I trauma center to determine the rates and predictors of death, organ failure, and infection in trauma patients with systolic blood pressure <or=to 90 mm Hg in the field or in the emergency department. Among the 208 patients with hemorrhagic shock (blood pressure or=to 24 hours, 39% developed infection and 24% developed organ failure. Increasing volume of crystalloid in the first 24 hours was strongly associated with increased mortality (p = 0.00001). Hemorrhage-induced hypotension in trauma patients is predictive of high mortality (54%) and morbidity. The requirement for large volumes of crystalloid was associated with increased mortality.