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2011, Number 3

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Rev Cub Med Int Emerg 2011; 10 (3)

Prognostic factors of death in patients with multiple traumas

Fonseca MJC, Gonzalez AJC, Frómeta Guerra A, Fonseca MTA

Language: Spanish
References: 21
Page: 2199-2209
PDF size: 199.31 Kb.


ABSTRACT

Introduction: Authors consider that the appropriate identification of different factors predicting death due to multiple traumas will allows a better medical care to patients.
Methods: A cohort study was conducted in patients presenting with multiple trauma seen in the Intensive Care Unit (ICU) of the “Carlos Manuel de Céspedes” Hospital from January 1, 2006 to December 31, 2007. The statistical analysis was based on the one-variation strategy consisting of the determination of relative risk for each of the risk factors hypothetically influential in the prognosis of death due to multiple traumas, as well as in the estimation of its 95% confidence intervals (CI).
Objectives: To determine the independent factors influencing on the prognosis of death in patients presenting multiple traumas.
Results: From 92 patients included in study 30 of them deceased (32,60%). According to the diagnostic category of patient underwent multiple trauma, including the surgical cranial trauma had 7 times more risk of dye, those with systemic inflammatory response had nine times more risk of dye, it was significant that when the mean blood pressure value was ‹ 80 mmHg to increase fivefold the risk of death.
Conclusions: The appearance of systemic inflammatory response syndrome is the independent factor with a great influence on death in patients presenting with multiple traumas, followed by the drop of mean blood pressure under 80 mmHg and the appearance of a multiple dysfunction of organs during the first 24 hours of admission. Age, sex, origin and ingestion of alcohol were not related to an increase in death rate in study cases. Other variables hypothetically described as influential in the poor evolution of patients, by example, the diagnostic category, the comorbid disease, acute respiratory failure, value of Glasgow's scale, and hemoglobin have not an independent influence on death.


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