LAUSR

OBJECTIVE To determine the prevalence, risk factors and functional results of chronic critical illness (CCI) in polytrauma patients. DESIGN single-center observational retrospective study. SETTING ICU at a tertiary hospital in Santander, Spain, between 2015 and 2019. PATIENTS adult trauma patients who survived beyond 48 hours after injury . CCI was defined as the need for mechanical ventilation for at least 14 days or tracheostomy for difficult weaning. MEASUREMENTS AND MAIN RESULTS 62/575 developed CCI. These patients were characterized by higher ISS score [17 (SD 10) vs. 13.8 (SD 8.2); p < 0.001] and higher NISS (26 (SD 11) vs. 19.2 (SD 10.5); p:0.001). CCI group had greater proportion of hospital-acquired infections infectious processes (100% vs. 18.1%; p < 0.001), and acute kidney failure (33.9% vs. 22.8% p< 0.001). During the first 24 hours of admission, CCI group required in a greater proportion surgical intervention (50% vs. 29%; p: 0.001), and blood products (31.3% vs. 20.5%; p< 0.047). Hospital ward stay was longer in CCI patients [9.5 days (IQR 5-16.9) vs. 43.9 (IQR 30.3-53) p < 0.001]. The CCI mortality was higher (19.5% vs. 8.1%; p:0.004). Surgical intervention in the first 24 hours (OR 2.5 95% CI 1.1-4.1) age (> 55 years) (OR 2.1 95%CI 1.1-4.2), ISS score (OR 1.1 95%CI 1.02-1.3), GCS score (OR 0.8 95%CI 0.4-23.2) and multiple organ failure (OR 9.5 95%CI 3.9-23.2) were predictors of CCI in the multivariate analysis. CONCLUSIONS CCI after severe trauma appears in a considerable proportion of patients. Early identification and implementation of specific interventions could change the evolution of this process.