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Predictive factors of mortality in patients with pelvic fracture and shock submitted to extraperitoneal pelvic packing
INTRODUCTION: in recent decades, the extraperitoneal pelvic packing technique has been disseminated, but there are still few studies. Thus, it was decided to analyze the results of extraperitoneal pelvic tamponade, in patients with pelvic fracture and shock, in order to identify predictive factors f...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Colégio Brasileiro de Cirurgiões
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578839/ https://www.ncbi.nlm.nih.gov/pubmed/36197344 http://dx.doi.org/10.1590/0100-6991e-20223259-en |
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author | FONSECA, VINICIUS CORDEIRO MENEGOZZO, CARLOS AUGUSTO METIDIERI CARDOSO, JULIANA MYNSSEN DA FONSECA BERNINI, CELSO OLIVEIRA UTIYAMA, EDIVALDO MASSAZO POGGETTI, RENATO SÉRGIO |
author_facet | FONSECA, VINICIUS CORDEIRO MENEGOZZO, CARLOS AUGUSTO METIDIERI CARDOSO, JULIANA MYNSSEN DA FONSECA BERNINI, CELSO OLIVEIRA UTIYAMA, EDIVALDO MASSAZO POGGETTI, RENATO SÉRGIO |
author_sort | FONSECA, VINICIUS CORDEIRO |
collection | PubMed |
description | INTRODUCTION: in recent decades, the extraperitoneal pelvic packing technique has been disseminated, but there are still few studies. Thus, it was decided to analyze the results of extraperitoneal pelvic tamponade, in patients with pelvic fracture and shock, in order to identify predictive factors for mortality. METHODS: a retrospective review of medical records of patients submitted to extraperitoneal pelvic packing was conduced. We analyzed their characteristics, prehospital and emergency room data, pelvic fracture classification, associated and severity injuries, laboratory and imaging exams, data on packing, arteriography, and other procedures performed, complications, hemodynamic parameters, and amount of transfused blood products before and after packing. RESULTS: data were analyzed from 51 patients, who showed signs of shock from prehospital care, presence of acidosis, with high base deficit and arterial lactate levels. Most patients underwent multiple surgical procedures due to severe associated injuries. The incidence of coagulopathy was 70.58%, and overall mortality was 56.86%. The group of non-surviving patients presented significantly higher age, prehospital endotracheal intubation, and lower Glasgow Coma Scale scores (p<0.05). The same group presented, before and after extraperitoneal pelvic packing, significantly worse hemodynamic parameters of mean arterial pressure, pH, base deficit, hemoglobin, and arterial lactate (p<0.05). The non-surviving group received significantly more units of packed red blood cells, fresh frozen plasma and platelets within 24 hours following extraperitoneal pelvic packing (p<0.05). CONCLUSION: age and base deficit are independent predictors of mortality in patients submitted to extraperitoneal pelvic packing. |
format | Online Article Text |
id | pubmed-10578839 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Colégio Brasileiro de Cirurgiões |
record_format | MEDLINE/PubMed |
spelling | pubmed-105788392023-10-17 Predictive factors of mortality in patients with pelvic fracture and shock submitted to extraperitoneal pelvic packing FONSECA, VINICIUS CORDEIRO MENEGOZZO, CARLOS AUGUSTO METIDIERI CARDOSO, JULIANA MYNSSEN DA FONSECA BERNINI, CELSO OLIVEIRA UTIYAMA, EDIVALDO MASSAZO POGGETTI, RENATO SÉRGIO Rev Col Bras Cir Original Article INTRODUCTION: in recent decades, the extraperitoneal pelvic packing technique has been disseminated, but there are still few studies. Thus, it was decided to analyze the results of extraperitoneal pelvic tamponade, in patients with pelvic fracture and shock, in order to identify predictive factors for mortality. METHODS: a retrospective review of medical records of patients submitted to extraperitoneal pelvic packing was conduced. We analyzed their characteristics, prehospital and emergency room data, pelvic fracture classification, associated and severity injuries, laboratory and imaging exams, data on packing, arteriography, and other procedures performed, complications, hemodynamic parameters, and amount of transfused blood products before and after packing. RESULTS: data were analyzed from 51 patients, who showed signs of shock from prehospital care, presence of acidosis, with high base deficit and arterial lactate levels. Most patients underwent multiple surgical procedures due to severe associated injuries. The incidence of coagulopathy was 70.58%, and overall mortality was 56.86%. The group of non-surviving patients presented significantly higher age, prehospital endotracheal intubation, and lower Glasgow Coma Scale scores (p<0.05). The same group presented, before and after extraperitoneal pelvic packing, significantly worse hemodynamic parameters of mean arterial pressure, pH, base deficit, hemoglobin, and arterial lactate (p<0.05). The non-surviving group received significantly more units of packed red blood cells, fresh frozen plasma and platelets within 24 hours following extraperitoneal pelvic packing (p<0.05). CONCLUSION: age and base deficit are independent predictors of mortality in patients submitted to extraperitoneal pelvic packing. Colégio Brasileiro de Cirurgiões 2022-09-21 /pmc/articles/PMC10578839/ /pubmed/36197344 http://dx.doi.org/10.1590/0100-6991e-20223259-en Text en © 2022 Revista do Colégio Brasileiro de Cirurgiões https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License |
spellingShingle | Original Article FONSECA, VINICIUS CORDEIRO MENEGOZZO, CARLOS AUGUSTO METIDIERI CARDOSO, JULIANA MYNSSEN DA FONSECA BERNINI, CELSO OLIVEIRA UTIYAMA, EDIVALDO MASSAZO POGGETTI, RENATO SÉRGIO Predictive factors of mortality in patients with pelvic fracture and shock submitted to extraperitoneal pelvic packing |
title | Predictive factors of mortality in patients with pelvic fracture and shock submitted to extraperitoneal pelvic packing |
title_full | Predictive factors of mortality in patients with pelvic fracture and shock submitted to extraperitoneal pelvic packing |
title_fullStr | Predictive factors of mortality in patients with pelvic fracture and shock submitted to extraperitoneal pelvic packing |
title_full_unstemmed | Predictive factors of mortality in patients with pelvic fracture and shock submitted to extraperitoneal pelvic packing |
title_short | Predictive factors of mortality in patients with pelvic fracture and shock submitted to extraperitoneal pelvic packing |
title_sort | predictive factors of mortality in patients with pelvic fracture and shock submitted to extraperitoneal pelvic packing |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578839/ https://www.ncbi.nlm.nih.gov/pubmed/36197344 http://dx.doi.org/10.1590/0100-6991e-20223259-en |
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