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Rev. méd. Chile ; 147(10): 1256-1265, oct. 2019. tab
Artículo en Español | LILACS | ID: biblio-1058592

RESUMEN

Background: Trauma is the main cause of death among people aged 5 to 44 years. Aim: To describe features, treatment and evolution of trauma patients admitted to an emergency room. Material and Methods: Adult patients admitted in the emergency department of a public hospital due to severe trauma were studied and followed during their hospital stay. Results: We included 114 patients aged 40 ± 17 years (78%men) with an injury severity score of 21 ± 11. Trauma was penetrating in 43%. Traumatic brain injury (TBI) was the most common diagnosis in 46%. In the emergency room, 8% had hypotension, 5% required vasopressors and 23% required mechanical ventilation. The initial lactate was 3.6 ± 2.9 mmol/L. Sixty-five patients (57%) required emergency surgery. The intraoperative lactate was 3 ± 1.7 mmol/L and 20% required vasopressors. Sixty-four patients (56%) were admitted to the ICU, with APACHEII and SOFA scores of 16 ± 8 and 5 ± 3, respectively. ICU lactate was 3.2±1.5 mmol/L. In the ICU 40% required vasopressors and 63% mechanical ventilation. Thirty two percent had coagulopathy, 43% received transfusions and 10% required massive transfusions. The hospital stay was 13 (6-32) days, being significantly longer in patients with TBI. ICU and hospital mortalities were 12.5 and 18.4% respectively. The only predictor for mortality was the APACHEII score (Hazard Ratio 1.18, 95% confidence intervals 1.03-1.36). Conclusions: APACHE score was a predictor of mortality in this group of patients.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Heridas y Lesiones/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Hospitales Generales/estadística & datos numéricos , Puntaje de Gravedad del Traumatismo , Chile/epidemiología , Análisis Multivariante , Estudios Prospectivos , Mortalidad Hospitalaria , Distribución por Sexo , Estadísticas no Paramétricas , APACHE , Lesiones Traumáticas del Encéfalo/epidemiología , Unidades de Cuidados Intensivos/estadística & datos numéricos , Tiempo de Internación
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