RESUMO
BACKGROUND: Multiple traumatic injuries are severe conditions with a high risk of complications. Hemorrhage, multiple organ failure syndrome (MOFS), systemic inflammatory response syndrome (SIRS) and sepsis are the most dangerous sequelae. ARDS (acute respiratory distress syndrome) is a part of MOFS. Despite new strategies of prevention and care, the mortality associated with these conditions still remains high. MATERIALS AND METHODS: We conducted a retrospective study of the surgical management tactic of 145 patients with multiple trauma complicated by ARDS. All patients were treated in Ivano-Frankivsk Regional Clinical Hospital between 2007 and 2012. There were 118 (81.4%) males and 27 (18.6%) females. Patients were divided into two age groups. Group I consisted of 113 (78%) patients aged 18-64 years, including 106 (94%) males and 7 (6%) females. Group II consisted of 32 (22%) patients over 65 years old, with 7 (21.8%) males and 25 (78.2%) females. AISS-NISS (Abbreviated Injury Severity Score - New Injury Severity Score) scores were 55.9±1.312 in Group I and 54.9±2.43 in Group II. RESULTS: The difference in emergency surgery timing between Group I and II was not significant (p>0.05). Age was an important criterion in defining optimal time of osteosynthesis (p<0.01). The choice of osteosynthesis type did not depend on patient age in the early period of trauma (1-3 days) (p>0.05), but the surgical tactic was significantly different in the late period (8 days and more) (p<0.01). Active fracture management with a stable osteosynthesis technique (intramedullary nailing, plating and external fixation) was preferred in the younger age group. CONCLUSIONS: 1. The age of the patient is quite an important factor defining the surgical tactic. 2. However, neither age nor severity of injury to the anatomical segments is a reliable criterion for assessing the severity of a patient's condition.