Pogorzelski Gabriella F, Silva Taline Aal, Piazza Thamara, Lacerda Tomás M, Spencer Netto Fernando Ac, Jorge Amaury Cesar, Duarte Péricles Ad
College of Medicine, Western Parana State University, Cascavel, PR, Brazil.
Department of Surgery, Western Parana State University Hospital, Cascavel, PR, Brazil.
Open Access Emerg Med. 2018 Jul 27;10:81-88. doi: 10.2147/OAEM.S162695. eCollection 2018.
Trauma is a major cause of hospital admissions and is associated with manifold complications and high mortality rates. However, data on intensive care unit (ICU) admissions are scarce in developing and low-income countries, where its incidence has been increasing.
To analyze epidemiological and clinical factors and outcomes in adult trauma patients admitted to the ICU of a public teaching hospital in a developing country as well as to identify risk factors for complications in the ICU.
Retrospective cohort of adult trauma patients admitted to the general ICU of a public teaching hospital in southern Brazil in the year 2012. Demographic, clinical, and outcome data from the ICU were analyzed.
During the study period, 144 trauma patients were admitted (83% male, Acute Physiology and Chronic Health Evaluation Score II =18.6±7.2, age =33.3 years, 93% required mechanical ventilation). Of these, 60.4% suffered a traffic accident (52% motorcycle), and 31.2% were victims of violence (aggressions, gunshot wounds, or stabbing); 71% had brain trauma, 37% had chest trauma, and 21% had abdominal trauma. Patients with trauma presented a high incidence of complications, such as infections, acute renal failure, acute respiratory distress syndrome, and thrombocytopenia. The ICU mortality rate was 22.9%.
In a Brazilian public teaching ICU, there was a great variability of trauma etiologies (mainly traffic accidents with motorcycles and victims of violence); patients with trauma had a high incidence of complications and mortality in the ICU.
创伤是住院的主要原因,且与多种并发症及高死亡率相关。然而,在发病率不断上升的发展中国家和低收入国家,关于重症监护病房(ICU)收治情况的数据却很匮乏。
分析一家发展中国家公立教学医院ICU收治的成年创伤患者的流行病学、临床因素及预后情况,并确定ICU并发症的危险因素。
对2012年巴西南部一家公立教学医院普通ICU收治的成年创伤患者进行回顾性队列研究。分析了ICU的人口统计学、临床及预后数据。
在研究期间,共收治144例创伤患者(83%为男性,急性生理与慢性健康状况评分II=18.6±7.2,年龄=33.3岁,93%需要机械通气)。其中,60.4%遭遇交通事故(52%为摩托车事故),31.2%为暴力受害者(袭击、枪伤或刺伤);71%有脑外伤,37%有胸部外伤,21%有腹部外伤。创伤患者并发症发生率较高,如感染、急性肾衰竭、急性呼吸窘迫综合征和血小板减少症。ICU死亡率为22.9%。
在巴西一家公立教学医院的ICU中,创伤病因差异很大(主要是摩托车交通事故和暴力受害者);创伤患者在ICU的并发症发生率和死亡率较高。