Fatores associados ao óbito em pacientes submetidos à laparotomia pós trauma abdominal no Hospital Regional de São José

• Autor(a) principal: Schmitz, José Ricardo Grams
• Data de Publicação: 2017
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Repositório Universitário da Ânima (RUNA)
• Texto Completo: https://repositorio.animaeducacao.com.br/handle/ANIMA/9362
• topic: Ferimentos penetrantes; Ferimentos não penetrantes; Cavidade abdominal; Mortalidade; Laparotomia

Introduction: Abdominal trauma is an important cause of morbidity and mortality, and knowledge of the epidemiological and clinical context is necessary to assist in the initial evaluation of the patient. The standardization of criteria for surgical intervention or the choice of conservative treatment are extremely important to avoid complications or mortality due to abdominal trauma. Objective: To identify the factors associated with death in patients submitted to laparotomy after abdominal trauma at the Regional Hospital of São José. Methods: A case-control study analyzing 202 patient charts of abdominal trauma victims submitted to an exploratory laparotomy using an instrument for collecting data. Data Analysis in SPSS 18.0, chi-square test and p<0.05. Prevalence ratio with 95% CI. The study was approved by REC. Results: Prevalence of mortality in male patients (91%), younger than 55 years (82.4%), blunt trauma (58.8%), automobilistic accident (52.9%), Glasgow ≤8 (59.1%), SBP≥90mmHg, FC ≥100bpm (52.4%), Hb <10g/dL (52%), multiple lesions (61.8%), spleen and liver injuries (38.2% each), extra abdominal injuries (76.5%), associated thoracic trauma (64.7%), presence of complications (94.1%), hypovolemic shock (61.8%) and damage control surgery (51.5%). Conclusion: The factors associated with mortality with statistical significance (p <0.05) were advanced age, blunt trauma, altered GCS, SBP <90mmGh, Hb <10g/dL, multiple lesions, solid viscera (spleen, kidney and pancreas), associated traumas (thoracic and cranioencephalic), postoperative complications (hypovolemic / hemorrhagic shock, CRP, acute renal failure, acute respiratory insufficiency) and the need for damage control surgery.