1 research outputs found

    Trauma card铆aco penetrante: factores pron贸sticos Penetrating cardiac trauma: Prognostic factors

    No full text
    El pron贸stico de los pacientes con herida de coraz贸n depende del tipo y la magnitud de la lesi贸n, el soporte prehospitalario y el estado cl铆nico al ingresar a urgencias. El conocimiento de los factores de riesgo es el paso inicial para sugerir modificaciones en el tratamiento para mejorar el pron贸stico. Se presenta un estudio retrospectivo de cohortes. Se estudiaron 204 pacientes con herida de coraz贸n que fueron hospitalizados entre enero de 1997 y diciembre de 1999 en el Hospital Universitario San Vicente de Pa煤l, Medell铆n, Colombia. Los desenlaces que se analizaron fueron la mortalidad intraoperatoria y posoperatoria, y las complicaciones posoperatorias. Muri贸 el 10,3% de los pacientes; los pacientes con herida por arma de fuego, de dos o m谩s c谩maras y dos o m谩s heridas card铆acas, presentaron mayor riesgo de morir; el riesgo tambi茅n aument贸 con el incremento en el puntaje de los 铆ndices de trauma 驴PI?, 驴PTTI? y 驴PCTI?. El choque y la arritmia intraoperatorias se asocian independientemente con la mortalidad (OR=19,6 y 22,3, respectivamente). En 22,1% de los pacientes hubo complicaciones posoperatorias y no se encontr贸 asociaci贸n entre ellas y los factores estudiados. En conclusi贸n, se deben utilizar los 铆ndices de trauma para comparar los resultados obtenidos en diferentes instituciones. La asociaci贸n entre arritmia y choque intraoperatorios con mortalidad obliga a una reanimaci贸n m谩s agresiva con el fin de disminuir la mortalidad.Background: The prognosis of patients with cardiac trauma depends on the type and magnitude of their lesions, the prehospital support received and the clinical state at admission to the emergency unit. Knowledge of these factors allows treatment modifications, leading to an improved prognosis. Methods: Retrospective cohort study. Setting: Universidad de Antioquia and San Vicente de Pa煤l University Hospital, Medell铆n, Colombia. 204 patients suffering from cardiac trauma were studied between January 1st 1997 and December 31st 1999. Primary outcome was either intra- or postoperative death; secondary outcome was postoperative complications. Results: 90% were men. 10% of the patients died; the following factors increased the risk of death: lesions by firearm; lesions of two or more cardiac chambers, and two or more cardiac lesions; risk also becames, higher as scores in PI, PTTI and PCTI indexes increase. Logistic regression analysis revealed that intraoperative shock and arrhythmia were factors independently associated with mortality (OR: 19.6 and 22.3 respectively). Forty five patients (22%) suffered postoperative complications but no association was found between them and the factors studied. Conclusion: The use of trauma indexes is important when comparing results obtained at different institutions; the association between mortality and intraoperative shock and/or arrhythmia, should lead to more aggressive reanimation attempts in order to reduce the former
    corecore