RESUMO
BACKGROUND: Trauma death has traditionally been described as primarily occurring in young men exposed to penetrating trauma or road traffic accidents. The epidemiology of trauma fatalities in Europe may change as a result of the increasing proportion of elderly patients. The goal of this study was to describe age-related differences in trauma type, mechanism, cause and location of death in a well-defined European region. METHODS: We prospectively registered all trauma patients and severe burn patients in eastern Denmark over 12 consecutive months. We analyzed all trauma fatalities in our region regarding the trauma type, mechanism, cause and location of death. RESULTS: A total of 2,923 patients were registered, of which 292 (9.9%) died within 30 days. Mortality increased with age, with a mortality of 46.1% in patients older than 80 years old. Blunt trauma was the most frequent trauma type at all ages, but the trauma mechanism differed among ages, with falls constituting 46.8% of trauma deaths in the elderly. The primary cause of death was head and spine injuries across all age-groups. Death took place before arrival at the hospital in 45% of the cases, but death during primary admission became increasingly important with advanced age. CONCLUSION: Increasing age was associated with higher mortality, an increased proportion of falls and fatal head or spine injuries.
Assuntos
Ferimentos e Lesões/mortalidade , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Causas de Morte , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto JovemAssuntos
Analgésicos Opioides/efeitos adversos , Falência Renal Crônica/complicações , Insuficiência Respiratória/induzido quimicamente , Tramadol/efeitos adversos , Idoso , Analgésicos Opioides/uso terapêutico , Humanos , Masculino , Dor/etiologia , Insuficiência Respiratória/fisiopatologia , Tramadol/uso terapêuticoRESUMO
Computer analysis of blood gas measurements was used to evaluate the effect of a continuous axillary block on the circulation of the hand of a patient suffering from regional circulatory insufficiency due to ligation of the brachial artery. Venous blood samples drawn from the cephalic vein were analysed at 0, 1, 2.5 and 18 hours after the blockade. Improved circulation of the hand was indicated by decreased arterio-venous oxygen difference and increased venous oxygen partial pressure following the blockade. The advantage in using the extended blood gas analysis is the possibility of estimating the main factors influencing tissue oxygenation: oxygen capacity, oxygen partial pressure and the haemoglobin oxygen affinity.