Chico-Fernández M, Llompart-Pou J A, Guerrero-López F, Sánchez-Casado M, García-Sáez I, Mayor-García M D, Egea-Guerrero J, Fernández-Ortega J F, Bueno-González A, González-Robledo J, Servià-Goixart L, Roldán-Ramírez J, Ballesteros-Sanz M Á, Tejerina-Alvarez E, García-Fuentes C, Alberdi-Odriozola F
UCI de Trauma y Emergencias, Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España.
Servei de Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, España.
Med Intensiva. 2016 Aug-Sep;40(6):327-47. doi: 10.1016/j.medin.2015.07.011. Epub 2015 Oct 4.
To describe the characteristics and management of severe trauma disease in Spanish Intensive Care Units (ICUs). Registry of trauma in the ICU (RETRAUCI). Pilot phase.
A prospective, multicenter registry.
Thirteen Spanish ICUs.
Patients with trauma disease admitted to the ICU.
None.
Epidemiology, out-of-hospital attention, registry of injuries, resources utilization, complications and outcome were evaluated.
Patients, n=2242. Mean age 47.1±19.02 years. Males 79%. Blunt trauma 93.9%. Injury Severity Score 22.2±12.1, Revised Trauma Score 6.7±1.6. Non-intentional in 84.4% of the cases. The most common causes of trauma were traffic accidents followed by pedestrian and high-energy falls. Up to 12.4% were taking antiplatelet medication or anticoagulants. Almost 28% had a suspected or confirmed toxic influence in trauma. Up to 31.5% required an out-of-hospital artificial airway. The time from trauma to ICU admission was 4.7±5.3hours. At ICU admission, 68.5% were hemodynamically stable. Brain and chest injuries predominated. A large number of complications were documented. Mechanical ventilation was used in 69.5% of the patients (mean 8.2±9.9 days), of which 24.9% finally required a tracheostomy. The median duration of stay in the ICU and in hospital was 5 (range 3-13) and 9 (5-19) days, respectively. The ICU mortality rate was 12.3%, while the in-hospital mortality rate was 16.0%.
The pilot phase of the RETRAUCI offers a first impression of the epidemiology and management of trauma disease in Spanish ICUs.
描述西班牙重症监护病房(ICU)中严重创伤疾病的特征及管理情况。ICU创伤登记(RETRAUCI)。试点阶段。
一项前瞻性多中心登记研究。
13家西班牙ICU。
入住ICU的创伤疾病患者。
无。
对流行病学、院外救治情况、损伤登记、资源利用、并发症及结局进行评估。
患者共纳入2242例。平均年龄47.1±19.02岁。男性占79%。钝性创伤占93.9%。损伤严重度评分22.2±12.1,修订创伤评分6.7±1.6。84.4%的病例为非故意伤害。创伤最常见的原因是交通事故,其次是行人事故和高能坠落。高达12.4%的患者正在服用抗血小板药物或抗凝剂。近28%的患者在创伤中有疑似或确诊的中毒影响。高达31.5%的患者需要院外建立人工气道。从创伤到入住ICU的时间为4.7±5.(此处原文有误,应为5.3)3小时。入住ICU时,68.5%的患者血流动力学稳定。脑和胸部损伤最为常见。记录到大量并发症。69.5%的患者使用了机械通气(平均8.2±9.9天),其中24.9%最终需要气管切开术。在ICU和医院的中位住院时间分别为5天(范围3 - 13天)和9天(5 - 19天)。ICU死亡率为12.3%,而院内死亡率为16.0%。
RETRAUCI的试点阶段提供了西班牙ICU中创伤疾病流行病学和管理情况的初步印象。