Citation

Martín Quirós A, Borobia Pérez A, Pertejo Fernández A, Pérez Perilla P, Rivera Núñez A, Martínez Virto AM, Quintana Díaz M. Emergencias 2015; 27(6): 371-374.

Vernacular Title

Mortalidad en el traumatismo potencialmente grave atendido en un servicio de urgencias de tercer nivel. Evaluación de la escala pronóstico de mortalidad GAP.

Affiliation

Servicio de Urgencias, Hospital Universitario La Paz, IDIPAZ, Madrid, España. Facultad de Medicina, Universidad Autónoma de Madrid, España.

Copyright

(Copyright © 2015, SEMES - Sociedad Española de Medicina de Urgencias y Emergencias)

DOI

unavailable

PMID

29094838

Abstract

OBJECTIVES: La mortalidad de nuestra serie de pacientes es baja en relación a lo publicado con anterioridad. El GAP es útil como escala pronóstica de mortalidad en nuestra cohorte de pacientes. MATERIAL AND METHODS: Retrospective observational study of all patients with potentially severe injuries treated in an emergency department (ED) over a period of 15 months. We recorded epidemiologic variables, cause of injury, type of transport, need for prehospital orotracheal intubation, substance abuse, Charlson Comorbidity Index (CCI), variables for the GAP prognostic score, destination on discharge from the ED and at the end of the episode, and mortality.

RESULTS: Data for 864 patients entered the final analysis. Mortality was higher in older patients (mean [SD] age, 57.9 [26.6] vs 41.1 [17.4], P<.05) and those with a higher mean CCI (3.3 [2.9] vs 0.9 [1.7]). Accident type was a precipitating factor associated with mortality (P<.001), but substance abuse was unrelated. Patients who died had lower mean Glasgow scores (9.1 [5.3] vs 14.8 [1.2], P<.001) and lower mean systolic and diastolic pressures (respectively, 113.8 [19.8] vs 131.3 [20.7] mm Hg, P=.012, and 60.1 [16.8] vs 77.7 [11.7] mm Hg, P=.002). Patients who died also had lower mean GAP scores than survivors (15.1 [4.8] vs 22.6 [1.7], P<.001). Risk factors that remained significant in the multivariate analysis were CCI (odds ratio [OR], 0.704; 95% CI, 0.52-0.96) and GAP score (OR, 1.8; 95% CI, 1.45-2.20).

CONCLUSION: Mortality in our patient series was lower than rates in previously published reports. The GAP score was a useful tool for predicting mortality in the series we studied.

Language: es

Language: es

Language: es

Language: es

Language: es

Keywords

Emergency department; Heridas; Injuries; Lesiones; Mortalidad; Mortality; Trauma severity indices; Urgencias; Wounds; Índice de gravedad del trauma