Citation

González-Robledo J, Martín-González F, Moreno-García M, Sánchez-Barba M, Sánchez-Hernández F. Med. Intensiva 2014; 39(7): 412-421.

Vernacular Title

Factores pronósticos relacionados con la mortalidad del paciente con trauma grave: desde la atención prehospitalaria hasta la Unidad de Cuidados Intensivos.

Affiliation

Cuidados Intensivos, Universidad de Salamanca, Salamanca, España.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.medin.2014.06.004

PMID

25189470

Abstract

OBJECTIVE: To identify factors related to mortality in adult trauma patients, analyzing the clinical, epidemiological and therapeutic characteristics at the pre-hospital levels, in the Emergency Care Department and in Intensive Care.

DESIGN: A retrospective, longitudinal descriptive study was carried out. Statistical analysis was performed using SPSS, MultBiplot and data mining methodology. SETTING: Adult multiple trauma patients admitted to the Salamanca Hospital Complex (Spain) from 2006 to 2011. MAIN VARIABLES OF INTEREST: Demographic variables, clinical, therapeutic and analytical data from the injury site to ICU admission. Evolution from ICU admission to hospital discharge.

RESULTS: A total of 497 patients with a median age of 45.5 years were included. Males predominated (76.7%). The main causes of injury were traffic accidents (56.1%), precipitation (18.4%) and falls (11%). The factors with the strongest association to increased mortality risk (P<.05) were age > 65 years (OR 3.15), head injuries (OR 3.1), pupillary abnormalities (OR 113.88), level of consciousness according to the Glasgow Coma Scale ≤ 8 (OR 12.97), and serum lactate levels > 4 mmol/L (OR 9.7).

CONCLUSIONS: The main risk factors identified in relation to the prognosis of trauma patients are referred to the presence of head injuries. Less widely known statistical techniques such as data mining or MultBiplot also underscore the importance of other factors such as lactate concentration. Trauma registries help assess the healthcare provided, with a view to adopting measures for improvement.

Language: es