TS08 *SIMPLE AND EFFECTIVE PROGNOSTIC CRITERIA DAMAGE CONTROL PROCEDURES

  1. F. S. Collete silva,
  2. R. Bardella,
  3. D. Garcia,
  4. R. S. Poggetti,
  5. D. Birolini,
  6. S. Rasslan

Article first published online: 27 APR 2009

DOI: 10.1111/j.1445-2197.2009.04934_8.x

Issue

ANZ Journal of Surgery

ANZ Journal of Surgery

Special Issue: Abstracts of the Royal Australasian College of Surgeons Annual Scientific Congress, 6–9 May 2009, Brisbane, Queensland, Australia

Volume 79, Issue Supplement s1, page A86, May 2009

Additional Information

How to Cite

Collete silva, F. S., Bardella, R., Garcia, D., Poggetti, R. S., Birolini, D. and Rasslan, S. (2009), TS08 *SIMPLE AND EFFECTIVE PROGNOSTIC CRITERIA DAMAGE CONTROL PROCEDURES. ANZ Journal of Surgery, 79: A86. doi: 10.1111/j.1445-2197.2009.04934_8.x

Author Information

  1. Emergency Surgery Hospital das Clinicas, Sao Paulo, Brazil

Publication History

  1. Issue published online: 27 APR 2009
  2. Article first published online: 27 APR 2009

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

Get PDF (76K)

To identify patients in whom damage control surgical procedures alone were not sufficient to achieve acceptable mortality rates.

Methods:   Hospital charts of trauma patients from October, 2004 to March, 2007, analyzed by: trauma severity indices, hemoglobin level, pH, PaO2, and bicarbonate level. Kruskal Wallis test and multiple comparison tests based on Z value (p ≤ 0.05).

Results:   37 patients were study. Mean age 34.7 ± 16.3 years (89% male). Blunt trauma was the most frequent (84%). They were divided into three groups according with death: Group I: mortality <24 h (n = 17), Group II: mortality >24 h (n = 5), and Group III: survivors (n = 15).

Prognostic variable by group

RTS I: 4.22 ± 2.39, II 5.22 ± 2.46; III: 7.17 ± 0.85 p = 0.0005. ____ISS I: 35.71 ± 11.05; II: 25.80 ± 11.08; III: 24.87 ± 10.55 p = 0.0268. ____TRISS I: 46.98 ± 35.40 II: 71.20 ± 35.54; III: 90.05 ± 20.56 p = 0.0004____GCS: I: 6.71 ± 4.37; II: 7.60 ± 6.31; III: 12.73 ± 2.81; p = 0.0017____Hemoglobin I 7.44 ± 3.80; II: 9.25 ± 3.54; III: 9.02 ± 3.36 p = 0.7555____pH: I: 6.96 ± 0.09; II: 7.10 ± 0.10; III: 7.15 ± 0.14 p = 0.0425____PaO2: I: 159.33 ± 58.35; II: 140.75 ± 82.40; III: 244.39 ± 92.39 p = 0.0231____Bicarbonate: I: 9.55 ± 0.98; II: 16.70 ± 2.28; III: 15.70 ± 4.32 p = 0.0045

Patients who died <24 h presented higher injury severity scores RTS, ISS, TRISS, Glasgow Coma Scale, and more severe metabolic disturbances than survivors. Among patients who survived at least 24 h, control of bleeding and of metabolic disturbances was effective in 95% of cases (only one death due to hemorrhage).

Conclusion:   severity indices and metabolic changes seem to correlate with the outcome of severe trauma patients subjected to surgical damage control procedures.

Get PDF (76K)