Resumo

MARINA-MARTINEZ, L. et al. «RETRATO» (REgistro de TRAuma grave de la provincia de TOledo): General view and mortality. Med. Intensiva [online]. 2010, vol.34, n.6, pp.379-387. ISSN 0210-5691.

Objective: To analyze the management and progression of the critical trauma patient. Design: A retrospective, descriptive analysis. Setting: The ICU in the province of Toledo. Patients: All patients with traumatic injury admitted during the 2001-2007 period (7 years). Main variables of interest: These include the variables at the scene of the accident, pre-hospitalization, during transportation, variables on admission and during development until discharge or death. Results: A total of 1090 trauma patients admitted were included. Of these, 79.5% were male, with an average age of 36.5 years (16% >65 years). There was a progressive decrease of patients from 2001 (142 patients) to 2007 (133 patients), with 46.9% admissions between May and September. A total of 29.4% did not belong to the health area. The causes were car accident (43.3%), fall from a height/fall (20.8%), motorcycle accident (13.8%), pedestrian being run over (6.6%). There were 2172 injuries; 30.1% had 3 injuries and 8.4% >4. The most frequently occurring injury was a head injury (33.7%), followed by thoracic trauma (20.2%) and orthopedic trauma (15.6%). 36.4% required surgery on the first day. Average length of stay in the ICU was 10.4±13.2 days. Time on mechanical ventilation was 7.3±12 days (median 1 day). Fifteen percent died in the ICU. This remains within the multivariable ICU mortality prediction model, including the pre-hospitalization variables: age (OR 1.05; 95% CI: 1.03-1.06), mydriasis (OR 2.6; 95% CI: 1.3-5.3), motor component of the Glascow Coma Score (GCS) (OR 0.7; 95% CI: 0.6-0.8), pre-hospitalization shock (OR 3.2; 95% CI: 1.8-5.5) and Injury Severity Score (ISS) (OR 1.1; 95% CI: 1.05-1.1). Conclusions: The use of multicenter trauma registers gives an overall view of trauma management and helps improve the care.

Palavras-chave : Multiple trauma; Critical care; Population register.

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