Atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivos / Features of patients with trauma admitted to an emergency room of a general hospital
Rev. méd. Chile
;
147(10): 1256-1265, oct. 2019. tab
Article
in Spanish
| LILACS
| ID: biblio-1058592
ABSTRACT
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 andMethods:
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.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Wounds and Injuries
/
Emergency Service, Hospital
/
Hospitals, General
Type of study:
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Chile
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2019
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Complejo Asistencial Dr. Sótero del Río/CL
/
Pontificia Universidad Católica de Chile/CL
/
Unidad de Cuidados Intensivos/CL
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