• Medicina intensiva · Aug 2010

    [ (REgistro de TRAuma grave de la provincia de TOledo): general view and mortality].

    • L Marina-Martínez, M Sánchez-Casado, V Hortiguela-Martin, M A Taberna-Izquierdo, A Raigal-Caño, A Pedrosa-Guerrero, M Quintana-Díaz, S Rodríguez-Villar, and S Rodríguez-Villa.
    • Hospital Virgen de la Salud, Toledo, España.
    • Med Intensiva. 2010 Aug 1;34(6):379-87.

    ObjectiveTo analyze the management and progression of the critical trauma patient.DesignA retrospective, descriptive analysis.SettingThe ICU in the province of Toledo.PatientsAll patients with traumatic injury admitted during the 2001-2007 period (7 years).Main Variables Of InterestThese include the variables at the scene of the accident, pre-hospitalization, during transportation, variables on admission and during development until discharge or death.ResultsA 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).ConclusionsThe use of multicenter trauma registers gives an overall view of trauma management and helps improve the care.Copyright © 2009 Elsevier España, S.L. y SEMICYUC. All rights reserved.

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