The Epidemiology of Chronic Critical Illness After Severe Traumatic Injury at Two Level–One Trauma Centers*

Objective: To determine the incidence and risk factors of chronic critical illness after severe blunt trauma. Design: Prospective observational cohort study (NCT01810328). Setting: Two level–one trauma centers in the United States. Patients: One hundred thirty-five adult blunt trauma patients with hemorrhagic shock who survived beyond 48 hours after injury. Interventions: None. Measurements and Main Results: Chronic critical illness was defined as an ICU stay lasting 14 days or more with evidence of persistent organ dysfunction. Three subjects (2%) died within the first 7 days, 107 (79%) exhibited rapid recovery and 25 (19%) progressed to chronic critical illness. Patients who developed chronic critical illness were older (55 vs 44-year-old; p = 0.01), had more severe shock (base deficit, –9.2 vs –5.5; p = 0.005), greater organ failure severity (Denver multiple organ failure score, 3.5 ± 2.4 vs 0.8 ± 1.1; p

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