الفهرس 
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Abstract
Summary
This study was done in the intensive care unit (ICU) of Minia university hospital in a period of six months duration starting from first of March, 2018 to the last of August , 2018 for 60 patients of both sexes and aimed to describe the predictive value of hematological markers and biological markers for outcome of adult trauma patients after ICU admission in age group from 18 to 65 years.
All patients were assessed and observed through their duration of management in the ICU by routine ICU monitoring, the Glasgow coma scale (GCS), and acute physiology and chronic health evaluation (APACHE II) scores on admission and before discharge , daily physical examination and routine and specific laboratory investigations and radiological procedures.
All patients were also assessed by the length of stay in the ICU, the need for mechanical ventilation and duration of ventilation and the presence of pre-admission comorbidities and its relation to outcome.
A record of most of complications (described secondary to different body systems) that had occurred in these patients during their duration of management in the ICU in the expression of morbidity and mortality was done.
Most cases were admitted from accident and emergency followed the theatre and finally the ward, The most common cause of injury in adults was road traffic accident, the commonest anatomical sites of injury are head and neck, The majority (86.5 %) of patients was admitted to the ICU after blunt trauma , and the majority of injuries were unintentional (95.6 %), The most common pre-existing comorbidities were a current smoking status , hypertension and diabetes mellitus.
The most common hospital complications amongst adult trauma patients admitted in the ICU were hypoxia, bronchospasm, sepsis, hypotension, pneumonia, anemia, thrombophlebitis, electrolytes imbalance, hyperglycemia, and urinary tract infection respectively and the mortality rate was 44.61%.
- We can follow up trauma patients by Hb ,TLC , prothrombin time , and INR.
- ABG changes in trauma patient and lactic acidosis in early 48h .
- Troponin elevated in head trauma , chest and cardiac trauma.
-We can replace APACHE II score by lab score (Hb ,TLC ,INR ,prothrombin time ,ABG ,Lactate and troponin) to predict outcomes of trauma patients in Intensive Care Unite.
Conclusion
We concluded that trauma constitutes a significant cause of admissions into the general ICU and a very high incidence of morbidities and mortality including increased hospital course complications.
We also concluded that the male to female ratio of adult trauma is 4.41:1, most cases are admitted from accident and emergency followed the theatre and finally the ward , the most common cause of injury in adults is road traffic accident, the commonest anatomical sites of injury are head and neck.
We also concluded that we can follow up patients with mild trauma by CBC as their hemoglobin and hematocrit may be affected.
We also concluded that trauma patients have coagulopathy disorders.
We also concluded that the lab score can be used in replace of APACHE II score to predict outcomes in trauma patients in the ICU.
Recommendations
We strongly recommend the establishment of local trauma management protocols that includes the pre hospital training and more efforts should be done to improve the trauma ICU programs.
We also recommend further studies to be done in the field of trauma trying to focus on the risk factors for occurrence of complications and the correlation between morbidity and mortality and these risk factors and the predictors of outcome.
We recommend the following studies to be done on a larger number of patients over a longer duration and in multiple trauma centers.
We also recommend the use of the acute physiology and chronic health evaluation (APACHE II) score and the injury severity score as predictors of occurrence of morbidity and mortality in adult trauma patients in the intensive care unit (ICU), we recommend the further studies to use the laboratory score to evaluate the trauma patients.