Analysis of risk factors associated with outcomes in road traffic injury patients with acute lung injury.

Over 50% of road traffic injury (RTI) patients experience post-traumatic acute lung injury (ALI) and it is, therefore, extremely important to identify the risk factors related to the poor outcomes associated with ALI in RTI populations. This study evaluated 19 potential risk factors associated with the outcomes of ALI in 366 RTI patients. They were divided into two groups: a 'favourable outcomes group' and an 'unfavourable outcomes group'. The results indicated that the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and the presence of gastrointestinal haemorrhage may help predict the outcomes of ALI in the early post-trauma phase of treatment. The duration of trauma and sepsis were shown to impact strongly on both the short- and long-term outcomes of ALI. Age (> 65 years) and disseminated intravascular coagulation in the early RTI phase were also independent risk factors for a poorer short- and long-term outcome in ALI.

The impact of clinical risk factors in the conversion from acute lung injury to acute respiratory distress syndrome in severe multiple trauma patients.

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are different stages of the same disease, the aggravated stage of ALI leading to ARDS. Patients with ARDS have higher hospital mortality rates and reduced long-term pulmonary function and quality of life. It is, therefore, important to prevent ALI converting to ARDS. This study evaluated 17 risk factors potentially associated with the conversion from ALI to ARDS in severe multiple trauma. The results indicate that the impact of pulmonary contusion, APACHE II score, gastrointestinal haemorrhage and disseminated intravascular coagulation may help to predict conversion from ALI to ARDS in the early phase after multiple-trauma injury. Trauma duration, in particular, strongly impacted the short- and long-term development of ALI. Being elderly (aged > or = 65 years) and undergoing multiple blood transfusions in the early phase were independent risk factors correlated with secondary sepsis, deterioration of pulmonary function and transfusion-related acute lung injury due to early multiple fluid resuscitation.