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BioMed Research International
Volume 2015, Article ID 354367, 9 pages
http://dx.doi.org/10.1155/2015/354367
Research Article

Prehospital Volume Therapy as an Independent Risk Factor after Trauma

1Trauma Surgery Department, Alfried Krupp Hospital Essen, Alfried-Krupp-Straße 21, 45131 Essen, Germany
2Surgery Department, Philippusstift Essen, Huelsmannstraße 17, 45355 Essen, Germany
3Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimer Straße 200, 51109 Cologne, Germany
4Trauma Surgery Department, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany

Received 1 January 2015; Revised 20 March 2015; Accepted 24 March 2015

Academic Editor: Stephen M. Cohn

Copyright © 2015 Bjoern Hussmann et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Prehospital volume therapy remains widely used after trauma, while evidence regarding its disadvantages is growing. The primary objective of this study was to investigate the volume administered in a prehospital setting as an independent risk factor for mortality. Material and Methods. Patients who met the following criteria were analyzed retrospectively: Injury Severity Score = 16, primary admission (between 2002 and 2010), and age = 16 years. The following data had to be available: volume administered (including packed red cells), blood pressure, Glasgow Coma Scale, therapeutic measures, and laboratory results. Following a univariate analysis, independent risk factors for mortality after trauma were investigated using a multivariate regression analysis. Results. A collective of 7,641 patients met the inclusion criteria, showing that increasing volumes administered in a prehospital setting were an independent risk factor for mortality (odds ratio: 1.34). This tendency was even more pronounced in patients without severe traumatic brain injury (TBI) (odds ratio: 2.71), while the opposite tendency was observed in patients with TBI. Conclusions. Prehospital volume therapy in patients without severe TBI represents an independent risk factor for mortality. In such cases, respiratory and circulatory conditions should be stabilized during permissive hypotension, and patient transfer should not be delayed.