Revista Cubana de Anestesiología y Reanimación (Jan 2019)
Risk factor for mortality in polytraumatized patients
Abstract
Introduction: Trauma is considered a public health problem worldwide. It is also an important cause of morbidity and mortality in the world. Objective: To identify risk factors and causes of death in polytraumatized patients. Methods: A descriptive, longitudinal and retrospective study was carried out in polytraumatized patients aged more than 18 years and surgically treated in the emergency unit of General Calixto García University Hospital during one year of observation. Sociodemographic variables were described, initial medical attention times were estimated, and the patient's clinical condition was described upon arrival at the operating room. The occurrence of death was considered based on its association with the predominant trauma and other perioperative factors. Univariate statistical procedures were used for risk factors. Multivariate analysis was used to predict prognostic factors for mortality. Results: There was a significant association between mortality and presence of diabetes mellitus and hypertension as associated diseases; as well as between multiple trauma with cranioencephalic trauma, the presence of hypovolemic shock, use of amines and Glasgow score below eight on arrival at the operating room, as well as the systemic inflammatory response, intracranial hypertension and acute respiratory failure as perioperative complications. Prognostic factors for death were hypovolemic shock, the systemic inflammatory response and lower Glasgow score. Conclusions: We identified nine risk factors with statistical significance and three prognostic factors of independent risk for mortality in polytraumatized patients.