Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 6 , ISSUE 3 ( September-December, 2017 ) > List of Articles

RESEARCH ARTICLE

Estado Funcional De Los Pacientes Con Trauma Craneo Encefalico Criticamente Enfermos

Wilmer F Botache, Juan Sanjuan, Maria Alejandra Rubio, Abner Lozano, Jaime Ruiz, Juan J Rubio

Citation Information : Botache WF, Sanjuan J, Rubio MA, Lozano A, Ruiz J, Rubio JJ. Estado Funcional De Los Pacientes Con Trauma Craneo Encefalico Criticamente Enfermos. Panam J Trauma Crit Care Emerg Surg 2017; 6 (3):177-181.

DOI: 10.5005/jp-journals-10030-1189

License: CC BY 3.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Antecedentes

El trauma craneoencefálico (TCE) continúa siendo la principal causa de morbimortalidad entre pacientes con trauma, la discapacidad y el compromiso cognitivo corresponde a la principal afectación configurando pronóstico a largo plazo.

Materiales y Métodos

Se realizó un estudio prospectivo tipo cohortes/casos y controles donde se incluyeron los pacientes con TCE severo (Escala Coma de Glasgow <8 y/o TAC anormal) que ingresaron a la unidad de cuidados intensivos Adultos durante 6 meses; se buscó determinar los desenlaces relacionados con el TCE en términos de mortalidad y discapacidad.

Resultados

Se encontraron 32 pacientes, más del 90% hombres, la mayoría con estabilidad hemodinámica al ingreso, se practicó neurocirugía en el 40% de los pacientes, aunque todos tenían indicación de monitoria de presión intracraneana solo se realizó en el 6% de los pacientes. El puntaje en la escala de desenlaces de Glasgow presento una mediana de 3 (RIC = 225 puntos). Se clasifico la severidad de la discapacidad en buena recuperacion 9,3%, discapacidad moderada 31,25%, discapacidad severa-muerte hasta en un 25%. Se determino que que un puntaje en la ECG se relacionaba con un GOS mas bajo; la neumonía aspirativa fue la principal complicación extracraneal, la mortalidad global correspondió a un 34.4%.

Conclusión

El TCE continua afectando de manera especial a las poblaciones jóvenes, con una alta incidencia de consecuencias discapacitantes y alta mortalidad, los centros de trauma deben implementar protocolos mas estrictos para promover la prevención y reforzar la aplicación de recomendaciones mundiales para mejores resultados en términos supervivencia y calidad de vida.

Significancia clinica

El trauma craneoencefálico, continua configurándose como la principal causa de morbimortalidad y discapacidad en adultos jovenes, con esta investigación se busca conocer y describir los datos epidemiológicos relevantes con respecto al desenlace de dicho trauma, conocimiento que es clave en el proceso de enseñanza buscando ofrecer mejores y mas efectivos abordajes en el momento de verse enfrentado a un trauma craneoencefálico.

Introduction

Traumatic brain injury (TBI) remains to be the leading cause of morbidity and mortality among patients with trauma, disability and neurocognitive commitment corresponds to the main affectation and set the long-term prognosis of these patients.

Materials and methods

It was performed a prospective cohort/cases and controls study, where all the patients with severe TBI (Glasgow Coma Scale (GCS) < 8 and/or abnormal CT scan) were admitted into the adult intensive care unit (ICU) for 6 months to determine the outcomes related to TBI in terms of mortality and disability.

Results

Thirty-two patients, more than 90% men, most with hemodynamic stability at admission; neurosurgery was practiced in 40% of patients. Although all had indication of intracranial pressure (ICP), monitoring was only performed in 6% of the patients. The score on the Glasgow outcome scale presented a median of 3 (IQR = 2p5 points). The severity of disability in good recovery was 9.3%, moderate disability 31.25%, and severe-dead disability was up to 25%. It was determined that a GCS score was associated with a lower GOS; aspiration pneumonia as the main extracranial complication was presented, overall mortality fell to 34.4% with only 12.5% of organ donors.

Conclusion

The TBI continues to affect especially young populations with a high incidence of disabling consequences and high mortality. The trauma centers should implement more strict protocols to promote prevention and to strengthen the implementation of global recommendations for better results in terms of survival and quality of life.

Clinical Significance

Traumatic brain injury continues being the main cause of morbidity and disability in young adults. This research seeks to know and describes the relevant epidemiological data regarding the outcome of this trauma, a knowledge that is key in the teaching process seeking better and more effective approaches at the moment of approach traumatic brain injury.

How to cite this article

Rubio MA, Rubio JJ, Lozano A, Ruiz J, Sanjuan J, Botache WF. Estado Funcional De Los Pacientes Con Trauma Craneo Encefalico Criticamente Enfermos. Panam J Trauma Crit Care Emerg Surg 2017;6(3):177-181.


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