Predictive factors of mortality in damage control surgery for abdominal trauma

Detalhes bibliográficos
Autor(a) principal: LEONARDI,LUIZA
Data de Publicação: 2022
Outros Autores: FONSECA,MARIANA KUMAIRA, BALDISSERA,NEIVA, CUNHA,CARLOS EDUARDO BASTIAN DA, PETRILLO,YURI THOMÉ MACHADO, DALCIN,ROBERTA RIGO, BREIGEIRON,RICARDO
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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spelling 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
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912022000100236
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/0100-6991e-20223390-en
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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)
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instname_str Colégio Brasileiro de Cirurgiões (CBC)
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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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