LAUSR

Critical Care Medicine • Volume 46 • Number 1 (Supplement) www.ccmjournal.org Learning Objectives: In modern trauma centers, the ability of prompt initial resuscitation and the computed tomography (CT) suite in the proximity of the emergency department (ED) allow hemodynamically unstable major trauma patients to undergo the CT scan before deciding operations or angiorams. We conducted this study to review the morbidities of hemodynamically unstable major trauma patients in the CT suite and to assess these events could be an independent risk factors for the in-hospital mortality. Methods: The medical records of trauma patients who were brought in our ED (1/2016 – 12/2016) were reviewed. We defined “hemodynamically unstable patients “as patients whose systolic blood pressure < 90 mmHg. To identify the risk factors for the inhospital mortality, the multivariate analysis was performed on factors statistically significantly more frequent in patients who died than in who survived on the univariate analysis. Results: There were 160 patients who met the inclusion criteria including 147 blunt traumas (89%). The median Injury Severity Score (ISS) was 18 (range 4 57). The in-hospital mortality rate was 11% (18/160). 136 patients (85%) underwent the CT scan directly from the ED. The incidence of events in the CT suite was 7% (10/136). Events included remained unstable throughout the test (n = 4), hypotension required pumping of blood products (n = 3), hypotension required the administration of pressors (n = 2), and the airway emergency needed intubation (n = 1). There were no deaths in the CT suite. Multivariate analysis revealed non-responders to the initial fluid resuscitation (Odds ratio [OR] 22.5 [95% CI 2.9 – 173.2], p = 0.003) and intubations in the ED (OR 4.0 [95% CI 1.1 – 15.1], p = 0.038) as independent risk factors for the in-hospital mortality; however, events in the CT suite was not (OR 0.9 [95% CI 0.108 – 7.9], p = 0.932). Conclusions: The CT scan could be done without significant morbidities for hemodynamically unstable major trauma patients if adequate airway management and circulatory support were provided. Events in the CT suite itself was not the independent risk factor for the in-hospital mortality.