Profile and Outcome of Trauma Patients Requiring Mechanical Ventilation in SICU: A Single-Centre Study with RETRASCORE-Based Mortality Analysis

Abstract

 Background: Trauma patients requiring mechanical ventilation represent a high-risk population with significant morbidity and mortality. Early identification of clinical predictors and outcome determinants is crucial for improving survival in Surgical Intensive Care Units (SICUs). This study assessed the clinical profile, RETRASCORE parameters, ventilatory characteristics, and outcomes of trauma patients requiring invasive mechanical ventilation in a tertiary-care SICU.

Methods: This single-centre observational study included 50 trauma patients admitted to the SICU who required mechanical ventilation for ≥12 hours. Patient data were collected from SICU records and trauma register data. Demographics, injury patterns, physiological parameters, ventilatory details, complications, and RETRASCORE components were evaluated. RETRASCORE values were calculated retrospectively and correlated with outcomes..

Results: Males comprised 76% of the cohort, with road traffic accidents being the predominant mechanism of injury (70%). Head injury (60%) and chest trauma (38%) were the most common trauma patterns. The mean GCS on admission was 9.2 ± 3.4, and the mean PaO₂/FiO₂ ratio was 212 ± 68. The average duration of mechanical ventilation was 6.8 days, with ventilator-associated pneumonia occurring in 18%. Tracheostomy was required in 20% of patients, and re-intubation in 10%. The overall ICU mortality rate was 30%, significantly associated with severe neurotrauma, low GCS, hypoxemia, and higher RETRASCORE values.

Conclusion: Trauma patients requiring mechanical ventilation exhibit substantial severity and a notable mortality burden. RETRASCORE demonstrated strong predictive value for adverse outcomes. Early recognition of high-risk indicators and optimization of ventilatory strategies may improve patient survival.