Predictive factors of mortality in damage control surgery for abdominal trauma
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Colégio Brasileiro de Cirurgiões |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912022000100236 |
Resumo: | ABSTRACT Introduction: damage control surgery (DCS) is well recognized as a surgical strategy for patients sustaining severe abdominal trauma. Literature suggests the indications, operative times, therapeutic procedures, laboratory parameters and intraoperative findings have a direct bearing on the outcomes. Objective: to analyze the clinical profile of patients undergoing DCS and determine predictors of morbidity and mortality. Methods: a retrospective cohort study was conducted on all patients undergoing DCS following abdominal trauma from November 2015 and December 2021. Data on subjects’ demographics, baseline presentation, mechanism of injury, associated injuries, injury severity scores, laboratory parameters, operative details, postoperative complications, length of stay and mortality were assessed. A binary logistic regression analysis was performed to determine potential risk factors for mortality. Results: During the study period, 696 patients underwent trauma laparotomy. Of these, 8.9% (n=62) were DCS, with more than 80% due to penetrating mechanisms. Overall mortality was 59.6%. In the logistic regression stratified by survival, several variables were significantly associated with mortality, including hypotension, and altered mental status at admission, intraoperative cardiorespiratory arrest, need for resuscitative thoracotomy, metabolic acidosis, hyperlactatemia, coagulopathy, fibrinolysis, and severity of the trauma injury scores. Conclusion: DCS may be appropriate in critically injured patients; however, it remains associated with significant morbidity and high mortality, even at specialized trauma care centers. From pre and postoperative clinical and laboratory parameters, it was possible to predict the risk of death in the studied sample. |
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Predictive factors of mortality in damage control surgery for abdominal traumaMultiple TraumaWounds and InjuriesInjury Severity ScoreIndicators of Morbidity and MortalityRisk FactorsABSTRACT Introduction: damage control surgery (DCS) is well recognized as a surgical strategy for patients sustaining severe abdominal trauma. Literature suggests the indications, operative times, therapeutic procedures, laboratory parameters and intraoperative findings have a direct bearing on the outcomes. Objective: to analyze the clinical profile of patients undergoing DCS and determine predictors of morbidity and mortality. Methods: a retrospective cohort study was conducted on all patients undergoing DCS following abdominal trauma from November 2015 and December 2021. Data on subjects’ demographics, baseline presentation, mechanism of injury, associated injuries, injury severity scores, laboratory parameters, operative details, postoperative complications, length of stay and mortality were assessed. A binary logistic regression analysis was performed to determine potential risk factors for mortality. Results: During the study period, 696 patients underwent trauma laparotomy. Of these, 8.9% (n=62) were DCS, with more than 80% due to penetrating mechanisms. Overall mortality was 59.6%. In the logistic regression stratified by survival, several variables were significantly associated with mortality, including hypotension, and altered mental status at admission, intraoperative cardiorespiratory arrest, need for resuscitative thoracotomy, metabolic acidosis, hyperlactatemia, coagulopathy, fibrinolysis, and severity of the trauma injury scores. Conclusion: DCS may be appropriate in critically injured patients; however, it remains associated with significant morbidity and high mortality, even at specialized trauma care centers. From pre and postoperative clinical and laboratory parameters, it was possible to predict the risk of death in the studied sample.Colégio Brasileiro de Cirurgiões2022-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912022000100236Revista do Colégio Brasileiro de Cirurgiões v.49 2022reponame:Revista do Colégio Brasileiro de Cirurgiõesinstname:Colégio Brasileiro de Cirurgiões (CBC)instacron:CBC10.1590/0100-6991e-20223390-eninfo:eu-repo/semantics/openAccessLEONARDI,LUIZAFONSECA,MARIANA KUMAIRABALDISSERA,NEIVACUNHA,CARLOS EDUARDO BASTIAN DAPETRILLO,YURI THOMÉ MACHADODALCIN,ROBERTA RIGOBREIGEIRON,RICARDOeng2022-08-30T00:00:00Zoai:scielo:S0100-69912022000100236Revistahttp://www.scielo.br/rcbcONGhttps://old.scielo.br/oai/scielo-oai.php||revistacbc@cbc.org.br1809-45460100-6991opendoar:2022-08-30T00:00Revista do Colégio Brasileiro de Cirurgiões - Colégio Brasileiro de Cirurgiões (CBC)false |
dc.title.none.fl_str_mv |
Predictive factors of mortality in damage control surgery for abdominal trauma |
title |
Predictive factors of mortality in damage control surgery for abdominal trauma |
spellingShingle |
Predictive factors of mortality in damage control surgery for abdominal trauma LEONARDI,LUIZA Multiple Trauma Wounds and Injuries Injury Severity Score Indicators of Morbidity and Mortality Risk Factors |
title_short |
Predictive factors of mortality in damage control surgery for abdominal trauma |
title_full |
Predictive factors of mortality in damage control surgery for abdominal trauma |
title_fullStr |
Predictive factors of mortality in damage control surgery for abdominal trauma |
title_full_unstemmed |
Predictive factors of mortality in damage control surgery for abdominal trauma |
title_sort |
Predictive factors of mortality in damage control surgery for abdominal trauma |
author |
LEONARDI,LUIZA |
author_facet |
LEONARDI,LUIZA FONSECA,MARIANA KUMAIRA BALDISSERA,NEIVA CUNHA,CARLOS EDUARDO BASTIAN DA PETRILLO,YURI THOMÉ MACHADO DALCIN,ROBERTA RIGO BREIGEIRON,RICARDO |
author_role |
author |
author2 |
FONSECA,MARIANA KUMAIRA BALDISSERA,NEIVA CUNHA,CARLOS EDUARDO BASTIAN DA PETRILLO,YURI THOMÉ MACHADO DALCIN,ROBERTA RIGO BREIGEIRON,RICARDO |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
LEONARDI,LUIZA FONSECA,MARIANA KUMAIRA BALDISSERA,NEIVA CUNHA,CARLOS EDUARDO BASTIAN DA PETRILLO,YURI THOMÉ MACHADO DALCIN,ROBERTA RIGO BREIGEIRON,RICARDO |
dc.subject.por.fl_str_mv |
Multiple Trauma Wounds and Injuries Injury Severity Score Indicators of Morbidity and Mortality Risk Factors |
topic |
Multiple Trauma Wounds and Injuries Injury Severity Score Indicators of Morbidity and Mortality Risk Factors |
description |
ABSTRACT Introduction: damage control surgery (DCS) is well recognized as a surgical strategy for patients sustaining severe abdominal trauma. Literature suggests the indications, operative times, therapeutic procedures, laboratory parameters and intraoperative findings have a direct bearing on the outcomes. Objective: to analyze the clinical profile of patients undergoing DCS and determine predictors of morbidity and mortality. Methods: a retrospective cohort study was conducted on all patients undergoing DCS following abdominal trauma from November 2015 and December 2021. Data on subjects’ demographics, baseline presentation, mechanism of injury, associated injuries, injury severity scores, laboratory parameters, operative details, postoperative complications, length of stay and mortality were assessed. A binary logistic regression analysis was performed to determine potential risk factors for mortality. Results: During the study period, 696 patients underwent trauma laparotomy. Of these, 8.9% (n=62) were DCS, with more than 80% due to penetrating mechanisms. Overall mortality was 59.6%. In the logistic regression stratified by survival, several variables were significantly associated with mortality, including hypotension, and altered mental status at admission, intraoperative cardiorespiratory arrest, need for resuscitative thoracotomy, metabolic acidosis, hyperlactatemia, coagulopathy, fibrinolysis, and severity of the trauma injury scores. Conclusion: DCS may be appropriate in critically injured patients; however, it remains associated with significant morbidity and high mortality, even at specialized trauma care centers. From pre and postoperative clinical and laboratory parameters, it was possible to predict the risk of death in the studied sample. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912022000100236 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912022000100236 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/0100-6991e-20223390-en |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgiões |
publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgiões |
dc.source.none.fl_str_mv |
Revista do Colégio Brasileiro de Cirurgiões v.49 2022 reponame:Revista do Colégio Brasileiro de Cirurgiões instname:Colégio Brasileiro de Cirurgiões (CBC) instacron:CBC |
instname_str |
Colégio Brasileiro de Cirurgiões (CBC) |
instacron_str |
CBC |
institution |
CBC |
reponame_str |
Revista do Colégio Brasileiro de Cirurgiões |
collection |
Revista do Colégio Brasileiro de Cirurgiões |
repository.name.fl_str_mv |
Revista do Colégio Brasileiro de Cirurgiões - Colégio Brasileiro de Cirurgiões (CBC) |
repository.mail.fl_str_mv |
||revistacbc@cbc.org.br |
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1754209215474302976 |