Evaluación de índices pronósticos en el trauma abdominal cerrado / Evaluation of Prognostic Indexes in Closed Abdominal Trauma

RESUMEN Introducción: El trauma accidental o intencional es la causa número uno de muerte en personas jóvenes. Objetivo: Evaluar la capacidad pronóstica en la predicción de la muerte de índices pronóstico en pacientes con trauma abdominal cerrado. Métodos: Se desarrolló un estudio observacional y descriptivo con fases analíticas en un universo de 72 pacientes con trauma abdominal cerrado en el Hospital Universitario "Celia Sánchez Manduley", Manzanillo, Granma, entre enero de 2016 a diciembre 2017. Los datos fueron procesados en el sistema Excel, construyéndose la curva de características operativas del receptor para el análisis de la efectividad de los índices pronósticos. Resultados: Predominaron los pacientes masculinos (70,83 por ciento) con una edad media de 43,31 años. El bazo fue el órgano más lesionado (5,56 por ciento) y el shock séptico la principal causa directa de la muerte (4,17 por ciento). El índice de severidad de lesiones, la escala revisada de trauma, la escala CRAMS y la metodología TRISS resultaron en una sensibilidad, de predicción de la muerte, de 91,02 por ciento, 87,5 por ciento, 83,5 por ciento y 95,8 por ciento respectivamente a un punto de corte de 25 puntos, 6 puntos, 7 puntos y hasta 19 por ciento respectivamente. Conclusiones: La metodología TRISS resultó ser el índice pronóstico de mayor sensibilidad y en consecuencia el más recomendado para la práctica clínica habitual(AU)

ABSTRACT Introduction: Accidental or intentional trauma is the leading cause of death among young people. Objective: To evaluate the mortality prediction capacity of prognostic indexes in patients with closed abdominal trauma. Methods: An observational and descriptive study with analytical phases was developed in a population of 72 patients with closed abdominal trauma, at Celia Sánchez Manduley University Hospital in Manzanillo, Granma Province, between January 2016 and December 2017. The data were processed in the Excel system, and the receiver operating characteristics curve was constructed to analyze the effectiveness of the prognostic indexes. Results: There was a predominance of male patients (70.83 percent) with a mean age of 43.31 years old. The spleen was the most injured organ (5.56 percent). The septic shock was the main direct cause of death (4.17 percent). The injury severity index, the revised trauma scale, the CRAMS scale, and the TRISS methodology produced a mortality prediction sensitivity of 91.02 percent, 87.5 percent, 83.5 percent, and 95.8 percent, respectively, at a cut point of 25, 6, and 7 points, and up to 19 percent, respectively. Conclusions: The TRISS methodology turned out to be the prognostic index with the highest sensitivity and, consequently, the most recommended for routine clinical practice(AU)

Surgical treatment for closed trauma of heart valves / 中华急诊医学杂志

Objective To evaluate the therapeutic strategy and effects of surgical treatment for patients with closed trauma of heart valves. Method A total of 32 patients, 28 male and 4 female, aged from 21 to 48 years old with closed trauma of heart valves treated with surgical intervention from June 1987 to November 2008 were retrospectively studied. The duration from trauma to surgical treatment ranged from 18 days to 4 years. Results There was no peri-operative mortality within 30 days. Clinical follow-up for one month to 22 years showed cerebral hemorrhage in only one patient 27 months later and sudden death in one patient probably due to choke of the valve.Conclusions The mortality of patients with closed trauma of heart valves may be decreased by timely and correct diagnosis and treatment, and the outcomes may be improved.

The value of MRI in diagnosis of Achilles tendon rupture / 中华创伤骨科杂志

Objective To evaluate MRI in diagnosis and follow-up of Achilles tendon rupture. Methods From April 2003 to May 2005, 24 cases of closed Achilles tendon rupture were examined in our department with MRI. It was performed through sagittal T1WI, T2WI, GE-STIR and axial TME imaging. Four cases were followed up with MRI after 4 to 8 weeks. Results MRI could determinate the severity and exact location of Achilles tendon rupture by demonstrating signal changes of Achilles tendon. In this series, complete rupture of Achilles tendon mostly occurred at the median part, with augmentation and high signal on T2WI. MRI demonstrated high signal on T2WI in partial rupture of Achilles tendon. The signal intensity in the four cases followed up by MRI was shown to decrease. Conclusion MRI is a valuable tool for clinical diagnosis and follow-up of Achilles tendon, because it provides enough information through signal changes at the tendon.