[Features of patients with trauma admitted to an emergency room of a general hospital]. / Atención de los pacientes con trauma grave durante los primeros días: evolución entre la urgencia, el pabellón y la unidad de cuidados intensivos.
Rev Med Chil
; 147(10): 1256-1265, 2019 Oct.
Article
in Es
| MEDLINE
| ID: mdl-32186633
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:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Wounds and Injuries
/
Emergency Service, Hospital
/
Hospitals, General
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America do sul
/
Chile
Language:
Es
Journal:
Rev Med Chil
Year:
2019
Document type:
Article
Affiliation country: