Atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivos

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 w...

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Autores principales:	Ruiz,Carolina, Vega,Eduardo, Barrera,Gonzalo, Ramos,Juan Pablo, Mimica,Ximena, Lisbona,María Luisa, Arau,Raúl, Fulle,Angello, Aquevedo,Andrés, Díaz,Miguel Ángel
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2019
Materias:	Brain Injuries, Traumatic Critical Care Epidemiology Multiple Trauma
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019001001256
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spelling	oai:scielo:S0034-988720190010012562020-01-16Atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivosRuiz,CarolinaVega,EduardoBarrera,GonzaloRamos,Juan PabloMimica,XimenaLisbona,María LuisaArau,RaúlFulle,AngelloAquevedo,AndrésDíaz,Miguel Ángel Brain Injuries, Traumatic Critical Care Epidemiology Multiple Trauma 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.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.147 n.10 20192019-10-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019001001256es10.4067/s0034-98872019001001256
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Brain Injuries, Traumatic Critical Care Epidemiology Multiple Trauma
spellingShingle	Brain Injuries, Traumatic Critical Care Epidemiology Multiple Trauma Ruiz,Carolina Vega,Eduardo Barrera,Gonzalo Ramos,Juan Pablo Mimica,Ximena Lisbona,María Luisa Arau,Raúl Fulle,Angello Aquevedo,Andrés Díaz,Miguel Ángel Atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivos
description	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.
author	Ruiz,Carolina Vega,Eduardo Barrera,Gonzalo Ramos,Juan Pablo Mimica,Ximena Lisbona,María Luisa Arau,Raúl Fulle,Angello Aquevedo,Andrés Díaz,Miguel Ángel
author_facet	Ruiz,Carolina Vega,Eduardo Barrera,Gonzalo Ramos,Juan Pablo Mimica,Ximena Lisbona,María Luisa Arau,Raúl Fulle,Angello Aquevedo,Andrés Díaz,Miguel Ángel
author_sort	Ruiz,Carolina
title	Atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivos
title_short	Atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivos
title_full	Atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivos
title_fullStr	Atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivos
title_full_unstemmed	Atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivos
title_sort	atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivos
publisher	Sociedad Médica de Santiago
publishDate	2019
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019001001256
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Atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivos

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