scholarly journals P080: What is the impact of post-intubation hypotension on mortality and in-hospital length of stay?

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S92
Author(s):  
D. Lachance-Perreault ◽  
J. Turgeon ◽  
V. Boucher ◽  
M. Émond
Keyword(s):  
Length Of Stay ◽  
Hospital Mortality ◽  
Vital Signs ◽  
Mortality Rates ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Historical Cohort ◽  
Resuscitation Room ◽  
Post Intubation ◽  
The Impact

Introduction: Hypotension is known to severely impact the prognosis of patients in need of acute care. Endotracheal intubation (EI) is a procedure that is often used in the emergency room for patients with severe conditions. Post-intubation hypotension (PHI) is a well-known adverse effect of EI, although the impact of PHI on mortality is still unclear. The objective of this study was therefore to evaluate the association between post-intubation hypotension (PIH) and in-hospital mortality rates and length of stay (LOS). Methods: Design: A historical cohort of patients admitted in a university-affiliated emergency department (ED) between 06/2011 and 05/2016 was constituted. Population: Patients aged ≥16 were included if pre-EI vital signs were available, if their intubation was performed in the resuscitation room, if no surgical access was needed and if EI was performed in ≤3 attempts. Measures: All clinical data including vitals were prospectively recorded using the software ReaScribe. Hypotension was defined as a systolic blood pressure ≤90 mmHg. The occurrence of PIH was assessed at 5, 15, 30 minutes and any time after intubation. Main outcomes were in-hospital mortality and hospital length of stay. Analyses: Univariate and multivariate analyses assessed the relation between PHI and outcomes. Results: A total of 497 patients were included in our analyses. Of these patients, 63 (12.7%) suffered from PIH at 5 minutes, 120 (24,1%) at 15 minutes, 168 (33,8%) at 30 minutes and 209 (42%) at any moment after intubation. Mortality rates were 42.9% (n = 27), 35.8% (n = 43), 33.9% (n = 57) and 30.6%(n = 64) for patients who presented PIH at the 4 time periods, respectively, while 26.74% patients died in the normotensive group. PIH at 5 (p = 0.006), 15 (p = 0.04) and 30 minutes (p = 0.05) was associated with a significant increase in overall post-intubation mortality. Mean LOS for patients who suffered from PIH was 16.7, 18.9, 17.3, 17.4 days compared to 19.5 (p = 0.22) days for the normotensive group. Conclusion: Early post-intubation hypotension at 5 minutes was strongly associated with an increased mortality. As for the in-hospital length of stay, PIH was not associated with an increased LOS. Our results show that PIH within 30 minutes of intubation is associated with an increased mortality rate and should therefore be aggressively treated or prevented.

Clinical and Economic Outcomes of Telemedicine Programs in the Intensive Care Unit: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 33 (7) ◽  
pp. 383-393 ◽  
Author(s):  
Jing Chen ◽  
Dalong Sun ◽  
Weiming Yang ◽  
Mingli Liu ◽  
Shufan Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Meta Analysis ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Icu Length Of Stay ◽  
The Impact

Objective: To evaluate the impact of telemedicine programs in intensive care unit (Tele-ICU) on ICU or hospital mortality or ICU or hospital length of stay and to summarize available data on implementation cost of Tele-ICU. Methods: Controlled trails or observational studies assessing outcomes of interest were identified by searching 7 electronic databases from inception to July 2016 and related journals and conference literatures between 2000 and 2016. Two reviewers independently screened searched records, extracted data, and assessed the quality of included studies. Random-effect models were applied to meta-analyses and sensitivity analysis. Results: Nineteen of 1035 records fulfilled the inclusion criteria. The pooled effects demonstrated that Tele-ICU programs were associated with reductions in ICU mortality (15 studies; risk ratio [RR], 0.83; 95% confidence interval [CI], 0.72 to 0.96; P = .01), hospital mortality (13 studies; RR, 0.74; 95% CIs, 0.58 to 0.96; P = .02), and ICU length of stay (9 studies; mean difference [MD], −0.63; 95% CI, −0.28 to 0.17; P = .007). However, there is no significant association between the reduction in hospital length of stay and Tele-ICU programs. Summary data concerning costs suggested approximately US$50 000 to US$100 000 per Tele-ICU bed was required to implement Tele-ICU programs for the first year. Hospital costs of US$2600 reduction to US$5600 increase per patient were estimated using Tele-ICU programs. Conclusions: This systematic review and meta-analysis provided limited evidence that Tele-ICU approaches may reduce the ICU and hospital mortality, shorten the ICU length of stay, but have no significant effect in hospital length of stay. Implementation of Tele-ICU programs substantially costs and its long-term cost-effectiveness is still unclear.

scholarly journals P045: Impact of post-intubation hypotension on mortality of patients in the emergency department (ED)

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S72-S73
Author(s):  
M. Emond ◽  
J. Turgeon ◽  
J. Shields ◽  
A. Nadeau
Keyword(s):  
Length Of Stay ◽  
Adverse Events ◽  
Endotracheal Intubation ◽  
Hospital Length ◽  
Trauma Centre ◽  
Hospital Length Of Stay ◽  
Hospital Death ◽  
Historical Cohort ◽  
Arterial Blood ◽  
Post Intubation

Introduction: Endotracheal intubation is frequently used in emergency departments and is often life saving, but it is also known to cause adverse events that can potentially lead to death. The main objective of this study is to evaluate mortality rates and duration of hospitalisation in patients who experienced post-intubation hypotension (PIH). Methods: A historical cohort of patients admitted between 07/2011 and 11/2014 at the ED of a level-one trauma centre. Patients were included if they were aged 16 years old or more, were intubated in the resuscitation room,had less than 3 intubation attempts, no need of surgical airway access, and had recorded vital signs prior to intubation. All clinical data including vitals were prospectively collected using ReaScribe®. PIH was defined by one measure or more of systolic arterial blood pressure <90 mm Hg. We retrospectively analysed the occurrence of PIH at 4 time points : 5, 15, 30 minutes, and at any moments after intubation. Study outcomes were in-hospital death and hospital length of stay in days (LOS). Univariate and multivariate analyses assessed the relation between PHI and outcomes. Results: 261 patients were included in the analyses. Amongst patient who experienced PIH, incidence of mortality was, respectively for each time estimate, of 31,0%, 33,3%, 28,6% and 26,9 % compared to 25,4% (p=0,5), 24,2% (p=0,1), 24,9% (p=0,5), and 25,4 % (p=0,8) in the normotensive group. The mean duration of hospitalisation in the group exposed to PIH was respectively of 26 (12,9-53,3), 22 (13,5-35,5), 19 (13,6-27,8), and 18 days (13.5-24.8) compared to 15,6 (12,9-18,9), 15,4 (12,6-18,8), 15,3 (12,3-19,1), and 15,5 (12.1-19.7) days (p=0,4). Conclusion: There was no association between the presence of post-intubation hypotension at 4 different time estimates and the in-hospital mortality nor the hospital length of stay. Further evaluation in specific sub-group should be foreseen to prevent adverse events from endotracheal intubation.

Validation and Calibration of the Risk Stratification Index

2017 ◽  
Vol 126 (4) ◽  
pp. 623-630 ◽  
Author(s):  
George F. Chamoun ◽  
Linyan Li ◽  
Nassib G. Chamoun ◽  
Vikas Saini ◽  
Daniel I. Sessler
Keyword(s):  
Length Of Stay ◽  
Risk Stratification ◽  
Hospital Mortality ◽  
Analysis Data ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Data Set ◽  
Procedure Codes ◽  
The Impact ◽  
Present On Admission

Abstract Background The Risk Stratification Index was developed from 35 million Medicare hospitalizations from 2001 to 2006 but has yet to be externally validated on an independent large national data set, nor has it been calibrated. Finally, the Medicare Analysis and Provider Review file now allows 25 rather than 9 diagnostic codes and 25 rather than 6 procedure codes and includes present-on-admission flags. The authors sought to validate the index on new data, test the impact of present-on-admission codes, test the impact of the expansion to 25 diagnostic and procedure codes, and calibrate the model. Methods The authors applied the original index coefficients to 39,753,036 records from the 2007–2012 Medicare Analysis data set and calibrated the model. The authors compared their results with 25 diagnostic and 25 procedure codes, with results after restricting the model to the first 9 diagnostic and 6 procedure codes and to codes present on admission. Results The original coefficients applied to the 2007–2012 data set yielded C statistics of 0.83 for 1-yr mortality, 0.84 for 30-day mortality, 0.94 for in-hospital mortality, and 0.86 for median length of stay—values nearly identical to those originally reported. Calibration equations performed well against observed outcomes. The 2007–2012 model discriminated similarly when codes were restricted to nine diagnostic and six procedure codes. Present-on-admission models were about 10% less predictive for in-hospital mortality and hospital length of stay but were comparably predictive for 30-day and 1-yr mortality. Conclusions Risk stratification performance was largely unchanged by additional diagnostic and procedure codes and only slightly worsened by restricting analysis to codes present on admission. The Risk Stratification Index, after calibration, thus provides excellent discrimination and calibration for important health services outcomes and thus appears to be a good basis for making hospital comparisons.

scholarly journals P079: A retrospective cohort study of the impact of age and post-intubation hypotension threshold on mortality

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S92
Author(s):  
D. Lachance-Perreault ◽  
J. Turgeon ◽  
V. Boucher ◽  
M. Émond
Keyword(s):  
Blood Pressure ◽  
Mortality Rate ◽  
Length Of Stay ◽  
Systolic Blood Pressure ◽  
Older Patients ◽  
Hospital Length Of Stay ◽  
Older Patient ◽  
Historical Cohort ◽  
Post Intubation ◽  
The Impact

Introduction: Endotracheal intubation (EI) is frequently performed in the emergency department (ED). Although this procedure is generally life-saving, EI is also known to cause adverse effects, such as hemodynamic alterations. A systolic blood pressure &lt;90 mmHg is the most commonly accepted definition of hypotension; however systolic blood pressure naturally increases with age. The National Trauma Triage Protocol now states that this threshold could be raised to 110 mmHg in older patients. Objective: to determine the impact of increasing the post-intubation hypotension (PIH) threshold to 110 mmHg on hospital length of stay and mortality in older patients. Methods: Design: A historical cohort of patients admitted in a level-1 trauma center ED between 06/2011 and 05/2016 was constituted. Population: Patients were included if pre-EI vital signs were available, their intubation was performed in the resuscitation room, were aged ≥65, if no surgical access was needed and if EI was performed in ≤3 attempts. Measures: All clinical data including vitals were prospectively recorded using the software ReaScribe. Main outcome was in-hospital mortality. Analyses: Univariate and multivariate analyses assessed the relation between PHI and outcomes. Results: A total of 181 patients were included. When using the 90-mmHg threshold, 92 patients suffered from PIH. Mean length of stay for these PIH patients was 18.9 days, compared to 12.0 days for non-hypotensive patients (P = 0.06). Mortality rate at 24 hours was 9.78% and 15.83% for PIH and non PIH patients, respectively (p = 0.2). The 110-mmHg threshold identified 33 additional PIH patients (n = 125) and their mean length of stay was 17.8 compared to 10.2 days for non PIH patients (P = 0.02). Mortality rate at 24 hours was 9.90% for PIH patients and 21.43% for non PIH patients (p = 0.02). Conclusion: PIH was associated with a significant increase in LOS when the PIH threshold is set at 110. Mortality rate is high in the intubated ED older patient and that increasing hypotension threshold for older patient seem to have no impact on patient mortality at 24 hours. Since our sample is limited, more research is needed to confirm these results.

scholarly journals Sex-Based Disparities in Venous Thromboembolism Sociodemographics and Outcomes: A National Inpatient Sample (NIS)-Based Analysis

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5918-5918
Author(s):  
Ariela L. Marshall ◽  
Adam C Bartley ◽  
Aneel A. Ashrani ◽  
Wilson I Gonsalves ◽  
Prashant Kapoor ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Mortality ◽  
Research Funding ◽  
Mortality Rates ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
National Inpatient Sample ◽  
Inclusion Criteria ◽  
Medical Comorbidities ◽  
Sociodemographic Differences

Abstract Background: Venous thromboembolism (VTE) contributes to significant morbidity, mortality, and socioeconomic burden. Though male sex is a known risk factor for recurrent VTE, there is a paucity of literature regarding sex-based sociodemographic differences as well as differences in VTE outcomes including hospital length of stay and mortality rates. Methods: We conducted a retrospective analysis from the National Inpatient Sample (NIS) database from 2012-2013. Inclusion criteria were age 18 years and older and primary discharge diagnosis of VTE Sociodemographic features and medical comorbidities were analyzed, as were hospital length of stay and in-hospital mortality rates. Results: 107,896 patients in the NIS, representing a national estimate of 539,480 patients hospitalized for VTE between 2012 and 2013, met inclusion criteria. 53% were female and 47% were male. Mean age was 63 years and on average women were older than men (65 years versus 62 years, p<0.001). There were significant differences between men and women with respect to race, primary insurance payor, and VTE location as well as medical comorbidities (Table 1). Median overall length of stay (LOS) was 4 days and in-hospital mortality rates were 2.1%. Female sex was associated with a small but significantly longer hospital LOS (RR 1.04, CI 1.03-1.05, p<0.001) which was also seen in subgroup analyses of lower extremity DVT (RR 1.05, CI 1.03-1.06, p<0.001) and pulmonary embolism (RR 1.03, CI 1.02-1.05, p<0.001) but not upper extremity (RR 1.04, CI 0.96-1.12, p=0.36). There were no significant sex-based differences in in-hospital mortality (2.2% in women versus 2.1% in men, p=0.15). In a multivariate model correcting for sociodemographic differences and medical comorbidities, there were no significant differences between women and men with respect to hospital LOS or in-hospital mortality (Table 2). Conclusion: We used data from the NIS to study a large number of patients hospitalized for VTE, and identified several sex-based disparities in sociodemographic factors and location of VTE. However, in a multivariable analysis correcting for these factors, sex was not associated with significant differences in hospital LOS or inpatient mortality rates. Disclosures Kapoor: Celgene: Research Funding; Takeda: Research Funding; Amgen: Research Funding.

scholarly journals Association of Emergency Department Waiting Times With Patient Experience in Admitted and Discharged Patients

2021 ◽  
Vol 8 ◽  
pp. 237437352110114
Author(s):  
Andrew Nyce ◽  
Snehal Gandhi ◽  
Brian Freeze ◽  
Joshua Bosire ◽  
Terry Ricca ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Patient Experience ◽  
Waiting Times ◽  
Hospital Length ◽  
Short Length ◽  
Hospital Length Of Stay ◽  
Patient’S Experience ◽  
Discharged Patients ◽  
The Impact

Prolonged waiting times are associated with worse patient experience in patients discharged from the emergency department (ED). However, it is unclear which component of the waiting times is most impactful to the patient experience and the impact on hospitalized patients. We performed a retrospective analysis of ED patients between July 2018 and March 30, 2020. In all, 3278 patients were included: 1477 patients were discharged from the ED, and 1680 were admitted. Discharged patients had a longer door-to-first provider and door-to-doctor time, but a shorter doctor-to-disposition, disposition-to-departure, and total ED time when compared to admitted patients. Some, but not all, components of waiting times were significantly higher in patients with suboptimal experience (<100th percentile). Prolonged door-to-doctor time was significantly associated with worse patient experience in discharged patients and in patients with hospital length of stay ≤4 days. Prolonged ED waiting times were significantly associated with worse patient experience in patients who were discharged from the ED and in inpatients with short length of stay. Door-to-doctor time seems to have the highest impact on the patient’s experience of these 2 groups.

scholarly journals Outcomes of Neutropenic Patients with Clostridium difficile Infection

2020 ◽  
Vol 41 (S1) ◽  
pp. s339-s340
Author(s):  
Roopali Sharma ◽  
Deepali Dixit ◽  
Sherin Pathickal ◽  
Jenny Park ◽  
Bernice Lee ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Treatment Failure ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
End Point ◽  
Neutropenic Patients

Background: Data from Clostridium difficile infection (CDI) in neutropenic patients are still scarce. Objective: To assess outcomes of CDI in patients with and without neutropenia. Methods: The study included a retrospective cohort of adult patients at 3 academic hospitals between January 2013 and December 2017. The 2 study arms were neutropenic patients (neutrophil count <500/mm3) and nonneutropenic patients with confirmed CDI episodes. The primary outcome evaluated the composite end point of all-cause in-hospital mortality, intensive care unit (ICU) admissions, and treatment failure at 7 days. The secondary outcome evaluated hospital length of stay. Results: Of 962 unique cases of CDI, 158 were neutropenic (59% men) and 804 were nonneutropenic (46% men). The median age was 57 years (IQR, 44–64) in the neutropenic group and 68 years (IQR, 56–79) in the nonneutropenic group. The median Charlson comorbidity score was 5 (IQR, 3–7.8) and 4 (IQR, 3–5) in the neutropenic and nonneutropenic groups, respectively. Regarding severity, 88.6% versus 48.9% were nonsevere, 8.2% versus 47% were severe, and 3.2% versus 4.1% were fulminant in the neutropenic and nonneutropenic groups, respectively. Also, 63% of patients (60.9% in nonneutropenic, 65.2% in neutropenic) were exposed to proton-pump inhibitors. A combination CDI treatment was required in 53.2% of neutropenic patients and 50.1% of nonneutropenic patients. The primary composite end point occurred in 27% of neutropenic patients versus 22% of nonneutropenic patients (P = .257), with an adjusted odds ratio of 1.30 (95% CI, 0.84–2.00). The median hospital length of stay after controlling for covariates was 21.3 days versus 14.2 days in the neutropenic and nonneutropenic groups, respectively (P < .001). Complications (defined as hypotension requiring vasopressors, ileus, or bowel perforation) were seen in 6.0% of the nonneutropenic group and 4.4% of the neutropenic group (P = .574), with an adjusted odds ratio of 0.61 (95% CI, 0.28–1.45). Conclusions: Neutropenic patients were younger and their cases were less severe; however, they had lower incidences of all-cause in-hospital mortality, ICU admissions, and treatment failure. Hospital length of stay was significantly shorter in the neutropenic group than in the nonneutropenic group.Funding: NoneDisclosures: None

scholarly journals 562. Tocilizumab for the Treatment of Severe COVID-19: A Retrospective, Multi-Center, Case-Matched Series

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S346-S346
Author(s):  
Sarah Norman ◽  
Sara Jones ◽  
David Reeves ◽  
Christian Cheatham
Keyword(s):  
Mechanical Ventilation ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Primary Outcome ◽  
Fungal Infections ◽  
Hospital Length ◽  
Hospitalized Patients ◽  
Hospital Length Of Stay ◽  
Matched Design ◽  
Median Hospital

Abstract Background At the time of this writing, there is no FDA approved medication for the treatment of COVID-19. One medication currently under investigation for COVID-19 treatment is tocilizumab, an interleukin-6 (IL-6) inhibitor. It has been shown there are increased levels of cytokines including IL-6 in severe COVID-19 hospitalized patients attributed to cytokine release syndrome (CRS). Therefore, inhibition of IL-6 receptors may lead to a reduction in cytokines and prevent progression of CRS. The purpose of this retrospective study is to utilize a case-matched design to investigate clinical outcomes associated with the use of tocilizumab in severe COVID-19 hospitalized patients. Methods This was a retrospective, multi-center, case-matched series matched 1:1 on age, BMI, and days since symptom onset. Inclusion criteria included ≥ 18 years of age, laboratory confirmed positive SARS-CoV-2 result, admitted to a community hospital from March 1st – May 8th, 2020, and received tocilizumab while admitted. The primary outcome was in-hospital mortality. Secondary outcomes included hospital length of stay, total mechanical ventilation days, mechanical ventilation mortality, and incidence of secondary bacterial or fungal infections. Results The following results are presented as tocilizumab vs control respectively. The primary outcome of in-hospital mortality for tocilizumab (n=26) vs control (n=26) was 10 (38%) vs 11 (42%) patients, p=0.777. The median hospital length of stay for tocilizumab vs control was 14 vs 11 days, p=0.275. The median days of mechanical ventilation for tocilizumab (n=21) vs control (n=15) was 8 vs 7 days, p=0.139, and the mechanical ventilation mortality was 10 (48%) vs 9 (60%) patients, p=0.463. In the tocilizumab group, for those expired (n=10) vs alive (n=16), 10 (100%) vs 7 (50%) patients respectively had a peak ferritin &gt; 600 ng/mL, and 6 (60%) vs 8 (50%) patients had a peak D-dimer &gt; 2,000 ng/mL. The incidence of secondary bacterial or fungal infections within 7 days of tocilizumab administration occurred in 5 (19%) patients. Conclusion These findings suggest that tocilizumab may be a beneficial treatment modality for severe COVID-19 patients. Larger, prospective, placebo-controlled trials are needed to further validate results. Disclosures Christian Cheatham, PharmD, BCIDP, Antimicrobial Resistance Solutions (Shareholder)

In-Hospital Mortality and Related Outcomes for Elevated Risk Acute Pulmonary Embolism Treated With Mechanical Thrombectomy Versus Routine Care

2021 ◽  
pp. 088506662110364
Author(s):  
Jennifer R. Buckley ◽  
Brandt C. Wible
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Routine Care ◽  
Hospital Length ◽  
Elevated Risk ◽  
Hospital Length Of Stay ◽  
Icu Length Of Stay

Purpose To compare in-hospital mortality and other hospitalization related outcomes of elevated risk patients (Pulmonary Embolism Severity Index [PESI] score of 4 or 5, and, European Society of Cardiology [ESC] classification of intermediate-high or high risk) with acute central pulmonary embolism (PE) treated with mechanical thrombectomy (MT) using the Inari FlowTriever device versus those treated with routine care (RC). Materials and Methods Retrospective data was collected of all patients with acute, central PE treated at a single institution over 2 concurrent 18-month periods. All collected patients were risk stratified using the PESI and ESC Guidelines. The comparison was made between patients with acute PE with PESI scores of 4 or 5, and, ESC classification of intermediate-high or high risk based on treatment type: MT and RC. The primary endpoint evaluated was in-hospital mortality. Secondary endpoints included intensive care unit (ICU) length of stay, total hospital length of stay, and 30-day readmission. Results Fifty-eight patients met inclusion criteria, 28 in the MT group and 30 in the RC group. Most RC patients were treated with systemic anticoagulation alone (24 of 30). In-hospital mortality was significantly lower for the MT group than for the RC group (3.6% vs 23.3%, P < .05), as was the average ICU length of stay (2.1 ± 1.2 vs 6.1 ± 8.6 days, P < .05). Total hospital length of stay and 30-day readmission rates were similar between MT and RC groups. Conclusion Initial retrospective comparison suggests MT can improve in-hospital mortality and decrease ICU length of stay for patients with acute, central PE of elevated risk (PESI 4 or 5, and, ESC intermediate-high or high risk).

scholarly journals The Impact of Selenium Supplementation on Trauma Patients—Systematic Review and Meta-Analysis

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 342
Author(s):  
Jen-Fu Huang ◽  
Chih-Po Hsu ◽  
Chun-Hsiang Ouyang ◽  
Chi-Tung Cheng ◽  
Chia-Cheng Wang ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Meta Analysis ◽  
Infectious Complications ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Current Evidence ◽  
Trauma Patients ◽  
Positive Effects ◽  
Standard Difference ◽  
The Impact

This study aimed to assess current evidence regarding the effect of selenium (Se) supplementation on the prognosis in patients sustaining trauma. MEDLINE, Embase, and Web of Science databases were searched with the following terms: “trace element”, “selenium”, “copper”, “zinc”, “injury”, and “trauma”. Seven studies were included in the meta-analysis. The pooled results showed that Se supplementation was associated with a lower mortality rate (OR 0.733, 95% CI: 0.586, 0.918, p = 0.007; heterogeneity, I2 = 0%). Regarding the incidence of infectious complications, there was no statistically significant benefit after analyzing the four studies (OR 0.942, 95% CI: 0.695, 1.277, p = 0.702; heterogeneity, I2 = 14.343%). The patients with Se supplementation had a reduced ICU length of stay (standard difference in means (SMD): −0.324, 95% CI: −0.382, −0.265, p < 0.001; heterogeneity, I2 = 0%) and lesser hospital length of stay (SMD: −0.243, 95% CI: −0.474, −0.012, p < 0.001; heterogeneity, I2 = 45.496%). Se supplementation after trauma confers positive effects in decreasing the mortality and length of ICU and hospital stay.

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