Premium
TS08
*SIMPLE AND EFFECTIVE PROGNOSTIC CRITERIA DAMAGE CONTROL PROCEDURES
Author(s) -
Collete silva F. S.,
Bardella R.,
Garcia D.,
Poggetti R. S.,
Birolini D.,
Rasslan S.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04934_8.x
Subject(s) - medicine , hemoglobin , gastroenterology , surgery
To identify patients in whom damage control surgical procedures alone were not sufficient to achieve acceptable mortality rates. Methods: Hospital charts of trauma patients from October, 2004 to March, 2007, analyzed by: trauma severity indices, hemoglobin level, pH, PaO2, and bicarbonate level. Kruskal Wallis test and multiple comparison tests based on Z value (p ≤ 0.05). Results: 37 patients were study. Mean age 34.7 ± 16.3 years (89% male). Blunt trauma was the most frequent (84%). They were divided into three groups according with death: Group I: mortality <24 h (n = 17), Group II: mortality >24 h (n = 5), and Group III: survivors (n = 15). Prognostic variable by group RTS I: 4.22 ± 2.39, II 5.22 ± 2.46; III: 7.17 ± 0.85 p = 0.0005. ____ISS I: 35.71 ± 11.05; II: 25.80 ± 11.08; III: 24.87 ± 10.55 p = 0.0268. ____TRISS I: 46.98 ± 35.40 II: 71.20 ± 35.54; III: 90.05 ± 20.56 p = 0.0004____GCS: I: 6.71 ± 4.37; II: 7.60 ± 6.31; III: 12.73 ± 2.81; p = 0.0017____Hemoglobin I 7.44 ± 3.80; II: 9.25 ± 3.54; III: 9.02 ± 3.36 p = 0.7555____pH: I: 6.96 ± 0.09; II: 7.10 ± 0.10; III: 7.15 ± 0.14 p = 0.0425____PaO2: I: 159.33 ± 58.35; II: 140.75 ± 82.40; III: 244.39 ± 92.39 p = 0.0231____Bicarbonate: I: 9.55 ± 0.98; II: 16.70 ± 2.28; III: 15.70 ± 4.32 p = 0.0045 Patients who died <24 h presented higher injury severity scores RTS, ISS, TRISS, Glasgow Coma Scale, and more severe metabolic disturbances than survivors. Among patients who survived at least 24 h, control of bleeding and of metabolic disturbances was effective in 95% of cases (only one death due to hemorrhage). Conclusion: severity indices and metabolic changes seem to correlate with the outcome of severe trauma patients subjected to surgical damage control procedures.