2012, Number 2
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Acta Med Cent 2012; 6 (2)
Fatal traumatic vascular lesions in the neck, thorax and abdomen: a five-year study
González LSO, Andrade RLE, Rodríguez VRC, Rodríguez RYR, Lugo JB, Barreto FEE
Language: Spanish
References: 20
Page:
PDF size: 57.98 Kb.
ABSTRACT
In the specialties of General Surgery and Angiology and Vascular Surgery, traumatic vascular injuries remain a major challenge. The main objective of this research was to characterize fatal traumatic vascular lesions in the neck, thorax and abdomen at the Arnaldo Milian Castro Provincial University Hospital during a 5 years period (2007-2011). An observational descriptive cross-sectional study was conducted. Of the universe (236 patients), a non-random sample of 213 patients was selected. The main results were: most patients (158) died on the scene and only 24% arrived alive at hospital. There were 434 injuries. The most common causative agents were traffic accidents (56.7%) and sharp weapons (31.6%). The chest was the most affected region with 45.6%. The predominant type of injury was the whole section of the spleen with 55.5%. Surgical treatment could only be applied in 10.3% of cases, with laparotomy and lateral suture being the most frequent surgical procedures (63.6%). Concerning damage control surgery performed in stage I, the hepatic packing (6 patients) was the most widely used procedure and 3 of the patients survived stage II and reached stage III, the hepatic packing was removed and the final repair was conducted. Of the deadly triad, acidosis was present in 100% of patients. The most common postoperative complications were surgical site infection with 54.5% and intra-abdominal abscesses with 36.4%. The hypovolemic shock was the predominant direct cause of death with 56.7%. Finally, it was determined that 36.5 years were not lived as a result of vascular lesions.
REFERENCES
Trunkey DD. Trauma. Sci Am. 1983;249:28-35.
García Gutiérrez A, Pardo Gómez G. Traumatismos. En: Cirugía. Vol II. La Habana: Ciencias Médicas; 2006. p. 541-49.
Soler VR. Traumatismos. La Habana: Centro de Información para la Defensa. 1993.
Solagberu BA, Adekanye AO, Ofoegbu CP. Epidemiology of trauma deaths. West Afr J Med. 2003; 22(2):177-81.
Demetriades D, Murray J, Sinz B. Epidemiology of major trauma and trauma deaths in Los Angeles County. J Am Coll Surg. 1998;187(4):373-83.
Accidentes del transporte en Cuba. En: Ministerio de Salud Pública. Dirección nacional de estadísticas [Internet]. La Habana: MINSAP; 2002. [citado 6 feb 2006];(1). Disponible en: http://www.dne.sld.cu/Libro/capitulo2/capitulo2.htm
Alberdi F. Azaldegui F. Marcos P. Laviñeta E. Metodología para la auditación de la calidad de un sistema traumatológico. Med Intensiva. 1999;23:373–9.
Pape HC. Remmers D. Rice J. Elbisch M. Krettek C. Tscherne H. Apprasial of early evaluations of blunt chest trauma: development of a standardized scoring system for initial clinical decision making. J Trauma. 2000;49(3):496–504.
Jones JM. Redmon AD. Uses and abuses of statistic models for evaluating trauma care. J Trauma. 1999; 37:45–8.
10.Rodríguez G. Misa M. Ponz F. Valdivia A. Mur N. Valoración de la atención de urgencias al paciente con trauma grave. Rev Cubana Cir. 2002;41(3):185–93.
11.O´Coonor PM, Stele JA, Dearden CH, Rocke LG, Fisher RB. Accident and Emergency Department. J Accid Emerg Med. 1996;13(1):9–10.
12.Azaldegui F, Alberdi F, Marcos P, Choperena G, Lara G, Reviejo K, et al. Estudio autópsico de los fallecimientos prehospitalarios y hospitalarios por accidente de tráfico en un ámbito provincial. Med Intensiva. 2001;25(1):1-7.
13.Acosta JA. Yang JC. Winchell RJ. Simons SK. Fortlage DA. Hollinsworth-Fridlund P, et al. Lethal injuries and time to death in a level I trauma center. J Am Coll Surg. 1998(186):528–533.
14.Boman H, Björnstig U, Hedelin A, Eriksson A. Avoidable death in two areas of Sweden- Analysis of death in hospital after injury. Eur J Surg. 1999;165:828 – 33.
15.Zielton SP, Capizzi PJ, Bannon MP, Farnell MB. Multisystem geriatric trauma. J Trauma. 1994;37(6): 985–92.
16.Kobusingye OC, Left RR. Hospital base trauma registries in Uganda. J Trauma. 2000;48:498 – 502.
17.Rodríguez Ríos Y, García Seco F, Lugo Jauriga B, Gómez Delgado R, Moro Rodríguez RT. Trauma vascular mortal. Ann Cir Cardiaca Vasc. 2005;11(2):64-8.
18.Azizzadeh A, Keyhani K, Miller CC, Coogan SM, Safi HJ, Estrera AL. Blunt traumatic aortic injury: initial experience with endovascular repair. J Vasc Surg. 2009 Jun;49(6):1403-8.
Arriciaga J. Chest trauma morbidity and mortality by penetrating injury. Rev Univ Guayaquil. [Internet]. 2010 Jul–Sep [citado 30 Abr 2011];108:13– 20. Disponible en: http://issuu.com/revistacientificaug/docs/revistacientificaug_n_108-
20.Tratamiento y evolución de los pacientes con traumatismo vascular periférico en el hospital escuela desde noviembre 2000 hasta el 30 de septiembre 2001. Rev Med Post UNAH [Internet]. 2002 Ene-Abr [citado 30 Abr 2011];7(1):[aprox. 5 p.]. Disponible en: http://www.bvs.hn/RMP/pdf/2002/pdf/Vol7-1-2002-8.pdf