1324: ABCDEF Bundle Elements and Mobility During Admission: Mortality Effects on the Critically Injured

Jackson Shampo, Kenneth Wenszell, Xian Luo-Owen, Natalie Mukherjee, Meghan Cochran-Yu, Lourdes Swentek, Sigrid Burruss, Susan Markovich, David Turay, Ihab Dorotta, Kaushik Mukherjee

Research output: Contribution to journalMeeting abstractpeer-review

Abstract

INTRODUCTION: ABCDEF bundle compliance correlates with decreased mortality in the critically ill, but it is unclear which bundle elements are most critical. We studied this question using ABC-123, an EPIC-EMR real-time score assigning 1-3 points per bundle element with higher numbers being better, and improvement in patient mobility during admission (IMA). METHOD(S): We reviewed 6 months of prospectivelycollected data on critically injured adults at an ACS-verified level I trauma center, including demographics, injury severity, Richmond Agitation and Sedation (RASS) Score, Confusion Assessment Method-ICU (CAM-ICU), maximum daily ABC- 123 score (ABC-MAX), and mobility level (bedrest/dangle/ stand/out of bed to chair/ambulate). ABC-123 score includes CPOT assessment, performance of SAT/SBT, reducing IV infusions for sedation, CAM-ICU score, compliance with mobility protocol, and family updates. Patients with mobility level improvement during admission were considered IMA+. Hospital mortality was the endpoint for logistic regression with ISS, head AIS, penetrating trauma, gender, age, ABCMAX subscores, and IMA. RESULT(S): We reviewed 172 patients (69.8% male, 16.3% penetrating, mean age 50.3+/-20.9 years, ISS 18.5+/-9.5, head AIS 2.3+/-2.5). 66.9% had delirium and 11.0% died. IMA+ patients had lower mortality than IMA- (1/48 [2.1%] vs. 18/124 [14.5%], p=0.027 [Fisher's exact]). ISS (OR 1.06[95%CI 1.03-1.10,p
Original languageAmerican English
Pages (from-to)669-669
Number of pages1
JournalCritical Care Medicine
Volume49
Issue number1
DOIs
StatePublished - Jan 1 2021

Disciplines

  • Medicine and Health Sciences
  • Emergency Medicine

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