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Perfil do traumatismo cranioencefálico e sua associação prognóstica com a dosagem sérica de creatinina à admissãoProfile of traumatic brain injury and its prognostic association with serum creatinine dosage at admissionEpidemiologia.Traumatismos craniocerebrais.Creatinina.Prognóstico.Epidemiology.Craniocerebral trauma.Creatinine.Prognosis.NeurocirurgiaINTRODUÇÃO: O traumatismo cranioencefálico (TCE), é um evento complexo, carregado de peculiaridades populacionais e regionais, com múltiplas causas e diferentes níveis de gravidade, possuindo um leque variado de prognósticos. OBJETIVOS: Caracterizar o perfil das vítimas de TCE no Triângulo Mineiro Sul e identificar associação prognóstica da dosagem sérica de creatinina à admissão. MÉTODOS: Estudo quantitativo, retrospectivo, baseado na análise de dados de prontuários de pacientes vítimas de TCE atendidos no Hospital de Clínicas da Universidade Federal do Triângulo Mineiro (HC-UFTM) na cidade de Uberaba, Minas Gerais, no período de janeiro de 2007 a dezembro de 2017. RESULTADOS: Foram incluídos 1347 pacientes. Predominou o sexo masculino (82,1%), a faixa etária dos adultos jovens (29,7%) e etiologia principal os acidentes de trânsito (57,2%) com destaque para os motociclísticos (21,9%). Alteração tomográfica foi evidenciada em 78,1% da amostra e a mortalidade foi de 17,3%. Nos idosos prevaleceram as quedas (47,3%), com destaque às quedas da própria altura (26,6%) como etiologia principal. O desfecho óbito apresentou significante associação com: sexo masculino (RC: 1,73; IC: 1,14-2,64), faixa etária dos idosos (RC: 2,35; IC: 1,66-3,34) e adultos (RC: 1,99; IC: 1,47-2,71), TCE moderado (RC: 3,31; IC:1,95-5,60) e grave (RC:12,78; IC:8,76-18,64), ferimentos por arma de fogo (FAF) (RC: 4,10; IC: 2,13- 7,89), presença de alteração tomográfica (RC: 5,28; IC:3,02-9,21), contusão cerebral (RC:1,44; IC:1,07-1,93), hematoma subdural (HSD) (RC:3,89; IC: 2,83-5,34), hemoventrículo (RC:3,29; IC:1,46-7,41), hemorragia subaranoidea traumática (HSAt) (RC: 1,42; IC: 1,02-1,96), inchaço cerebral (RC: 5,49; IC: 3,86-7,81), neurocirurgia (RC: 2,23; IC: 1,64-3,05) e trauma de tórax (RC:2,79; IC:1,74-4,45) e abdômen (2,10; IC: 1,11-3,95). O valor médio da creatinina sérica foi maior no sexo masculino, no TCE grave, na TC alterada, no HSD, no inchaço cerebral, no pneumoencéfalo, no desfecho óbito e teve valores crescentes quanto maior a faixa etária. A creatinina sérica associou-se ainda de forma independente ao desfecho óbito (após ajuste atráves de regressão logística multivariada) (RC: 1,64; IC: 1,25 – 2,15). O valor da creatinina sérica de 1,18 mg/dL representou o ponto de corte de melhor especificidade (89,12%; IC: 86,4-91,5) e sensibilidade (42,13%; IC: 34,8-49,7). CONCLUSÃO: Informações e associações epidemiológicas até então não relatadas em estudos retrospectivos brasileiros foram abordadas. Além de apresentar a creatinina sérica como promissor preditor laboratorial do TCE.INTRODUCTION: Traumatic brain injuryi (TBI), is a complex event, loaded with population and regional peculiarities, with multiple causes and different levels of severity, possessing a varied range of prognostics. OBJECTIVES: To characterize the profile of the victims of TBI in the Triângulo Mineiro Sul and to identify a prognostic association of serum creatinine dosage at admission. METHODS: This is a quantitative, retrospective study based on the analysis of data from medical records of patients who were victims of TBI attended at the General Hospital of the Federal University of Triângulo Mineiro (HC-UFTM) in the city of Uberaba, Minas Gerais, in the period of January From 2007 to December 2017. RESULTS: Included 1347 patients. Predominated males (82.1%), the age group of young adults (29.7%) and main etiology of traffic accidents (57.2%) with emphasis on motorcyclists (21.9%). Tomographic alteration was evidenced in 78.1% of the sample and mortality was 17.3%. In the elderly, falls (47.3%) prevailed, with emphasis on falls from their own height (26.6%) as the main etiology. The death outcome showed significant association with: male gender (OR: 1.73; CI: 1.14-2,64), age group of the elderly (RC: 2.35; IC: 1,66-3,34) and adults (OR: 1.99; CI: 1,47-2,71), moderate TBI (OR: 3.31; CI: 1.95-5,60) and severe TBI (OR: 12,78; CI: 8,76-18,64), gunshot wounds (OR: 4.10; CI: 2.13-7,89), presence of tomographic alteration (OR: 5.28; CI: 3,02- 9,21), cerebral contusion (OR: 1.44; CI: 1.07-1,93), subdural hematoma (SH) (OC: 3,89; CI: 2.83-5,34), hemoventriculus (OR: 3,29; CI: 1.46-7,41), traumatic subaranoid hemorrhage (TSH) (OR: 1.42; CI: 1.02-1.96), cerebral swelling (OR: 5.49; CI: 3,86- 7,81), neurosurgery (OR: 2.23; CI: 1,64-3,05), chest trauma (OR: 2,79; CI: 1,74-4,45) and abdômen trauma (OR: 2.10; CI: 1.11-3.95). The mean serum creatinine value was higher in males, severe TBI, altered tomographic, SH, cerebral swelling, pneumoencephalon, death outcome, and increased values the higher the age group. Serum creatinine was also independently associated with the outcome of death (after adjustment by multivariate logistic regression) (OR: 1.64; CI: 1.25 – 2.15). The serum creatinine value of 1.18 mg/dL represented the cutoff point for better specificity (89.12%; CI: 86,4-91,5) and sensitivity (42.13%; CI: 34.8-49,7). CONCLUSION: Epidemiological information and associations that have not been reported in brazilian retrospective studies have been approached. In addition to presenting serum creatinine as a promising laboratorial predictor of TBI.Universidade Federal do Triângulo MineiroInstituto de Ciências da Saúde - ICS::Programa de Pós-Graduação em Ciências da SaúdeBrasilUFTMPrograma de Pós-Graduação em Ciências da SaúdeDEZENA, Roberto Alexandre25506558856http://lattes.cnpq.br/7893995051585365CORREIA, Murillo Martins2019-08-29T19:24:29Z2019-07-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfapplication/pdfCORREIA, Murillo Martins. 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