By Asensio J.A., Trunkey D.D.
Evidence-based method of difficulties encountered in trauma and significant care surgical occasions
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Additional resources for Current Therapy of Trauma and Surgical Critical Care
Although physiologic reserve depends on more than age, it is difﬁcult to deﬁne, measure, and model the other factors that might be pertinent. Certainly compromised organ function may contribute to death following injury. 25 determined that liver cirrhosis, COPD, diabetes, congenital coagulopathy, and congenital heart disease were particularly detrimental following injury. Although many other such conditions are likely to contribute to outcome, the exact contribution of each condition will likely depend on the severity of the particular comorbidity in question.
Accid Anal Prev 29:53–56, 1997. 32. Bouillion B, Lefering R, Vorweg M: Trauma score systems: cologne validation study. J Trauma 42:652–658, 1997. 33. Markel J, Cayten CGT, Byrne DW, et al: Comparison between TRISS and ASCOT methods for controlling for injury severity. J Trauma 33:326–332, 1993. 34. Champion HR, Copes WS, Sacco WJ, et al: Improved predictions from A Severity of Characterization of Trauma (ASCOT) over Trauma and Injury Severity Score (TRISS): results of an independent evaluation.
Nearly 50% of injury deaths are alcohol related. Traumatic injury accounts for roughly the same num- The presence of alcohol signiﬁcantly affects the initial management of trauma patients. 5,6 Alcohol use may also increase the risk of death from serious injury. 7 Patients with a history of chronic alcohol use are more likely to have underlying medical conditions such as cardiomyopathy, liver disease, malnutrition, osteoporosis, and immunosuppression. Acute, in addition to chronic, alcohol use may also affect outcome from trauma.