Fatores associados ao óbito em pacientes submetidos à “Onda Vermelha”: ênfase na toracotomia de emergência

Rafael Valério Gonçalves; Ana Cecília Borges; Tatiane Rufino Vieira; Vinicius Rodrigues Taranto Nunes; Wagner Oseas Correa; Emanuelle Maria Sávio de Abreu; José Eduardo Magri Júnior; Carla Jorge Machado; Vivian Resende; Mario Pastore Neto

doi:10.23925/1984-4840.2017v19i4a4

Authors

Rafael Valério Gonçalves Universidade Federal de Minas Gerais Faculdade de Medicina
Ana Cecília Borges Universidade Federal de Minas Gerais Hospital Risoleta Tolentino Neves
Tatiane Rufino Vieira Universidade Federal de Minas Gerais Hospital Risoleta Tolentino Neves
Vinicius Rodrigues Taranto Nunes Universidade Federal de Minas Gerais Hospital Risoleta Tolentino Neves
Wagner Oseas Correa Universidade Federal de Minas Gerais Hospital Risoleta Tolentino Neves
Emanuelle Maria Sávio de Abreu
José Eduardo Magri Júnior Hospital Universitário São José / Hospital Universitário Ciências Médicas
Carla Jorge Machado Universidade Federal de Minas Gerais Faculdade de Medicina Departamento de Medicina Preventiva e Social
Vivian Resende
Mario Pastore Neto Universidade Federal de Minas Gerais Faculdade de Medicina Departamento de Cirurgia

DOI:

https://doi.org/10.23925/1984-4840.2017v19i4a4

Keywords:

wounds and injuries, thoracotomy, laparotomy, emergency service, hospital, emergency treatment

Abstract

Objective: To identify and analyze the factors associated with death, with a focus on performing laparotomy alone or associated with emergency thoracotomy. Method: Prospective longitudinal study of patients submitted to the “Onda Vermelha” protocol, after admission to the Risoleta Tolentino Neves Hospital, from 2011 to 2015. Descriptive analyses, Student’s t-test, χ2 test, and regression multiple binary logistics were used to identify predictors of death. Results: One hundred and thirty-two patients were studied, of which 47 (35.6%) died. The average age was 28 years old. The majority was male (90.9%), with penetrating trauma predominating in the study sample (91.7%). The trauma scores were compatible with moderate severity trauma. The average time of hospitalization and stay in the intensive care unit exceeded 10 days. Laparotomy and thoracotomy occurred in 72.7 and 28% of cases, respectively. Complications were severe for 38.6% of patients, and the most common lesions were gastrointestinal (48.5%) and abdominal vessels (28.8%). Thoracotomy, severe complications and abdominal vessel injury were more frequent among patients who died (p<0.001). Factors associated to death were: emergency thoracotomy (OR=6.9, p=0.002), severe complications (OR=6.1, p=0.010), and lesions to the abdominal and pelvic vessels (OR=16.8, p<0.001). Conclusion: Emergency thoracotomy was associated with higher odds of death, regardless of other factors, as well as the mechanism of penetrating trauma, complications and injuries to the abdominal and pelvic vessels. Survival in the presence of thoracotomy was 25.7% for victims of penetrating trauma.

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Author Biographies

Emanuelle Maria Sávio de Abreu

Universidade Federal de Minas Gerais
Hospital Risoleta Tolentino Neves

Vivian Resende

Universidade Federal de Minas Gerais
Faculdade de Medicina
Departamento de Cirurgia

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