Factores relacionados con evolución clínica desfavorable en pacientes con traumatismo torácico
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Date
2025-01-10
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Universidad Nacional de Trujillo
Abstract
Determinar los factores relacionados con una evolución clínica desfavorable en pacientes con traumatismo torácico.
Método: Estudio de casos y controles de 295 pacientes (123 casos y 172 controles) atendidos entre enero de 2015 y diciembre de 2019 en el Hospital Regional Docente de Trujillo y Hospital Belén de Trujillo. Las variables expuestas fueron edad, sexo, tipo de trauma, hemotórax, neumotórax, contusión pulmonar y la puntuación del Thoracic Trauma Severity Score (TTSS). Los casos fueron pacientes con una evolución clínica desfavorable que incluía cirugía mayor, ingreso a Unidad de Cuidados Intensivos, intubación, mortalidad y estancia hospitalaria prolongada.
Resultados: El odds ratio obtenido fue para la edad 0.69 [0.35–1.32], para el sexo 1.02 [0.56 – 1.88], para el tipo de trauma 1.17 [0.68 – 1.99], para el hemotórax 4.02 [2.38 – 6.78], para el neumotórax 2.14 [1.29 – 3.56] y para la contusión pulmonar 4.99 [2.92 – 8.53]. Se estimó el umbral para el TTSS donde se obtuvo un punto de corte mayor o igual a 7 con un área bajo la curva de 0.77 [IC 95%, 0.71 – 0.83].
Conclusiones: El hemotórax, neumotórax, la contusión pulmonar y el TTSS con una puntuación de 7 puntos o más son factores relacionados con una evolución clínica desfavorable.
Palabras clave: Lesiones torácicas, pronóstico, resultados clínicos
Abstract To determine the factors related to an unfavorable clinical evolution in patients with thoracic trauma. Method: Case-control study of 295 patients (123 cases and 172 controls) treated between January 2015 and December 2019 at the Trujillo Regional Teaching Hospital and the Belén Hospital in Trujillo. The variables exposed were age, sex, type of trauma, hemothorax, pneumothorax, pulmonary contusion and the Thoracic Trauma Severity Score (TTSS). The cases were patients with an unfavorable clinical evolution that included major surgery, admission to the Intensive Care Unit, intubation, mortality and prolonged hospital stay. Results: The odds ratio obtained was 0.69 [0.35–1.32] for age, 1.02 [0.56 – 1.88] for sex, 1.17 [0.68 – 1.99] for trauma type, 4.02 [2.38 – 6.78] for hemothorax, 2.14 [1.29 – 3.56] for pneumothorax and 4.99 [2.92 – 8.53] for pulmonary contusion. The threshold for TSS was estimated, where a cut-off point greater than or equal to 7 was obtained with an area under the curve of 0.77 [95% CI, 0.71 – 0.83]. Conclusions: Hemothorax, pneumothorax, pulmonary contusion, and TTSS with a score of 7 points or more are factors related to an unfavorable clinical evolution.
Abstract To determine the factors related to an unfavorable clinical evolution in patients with thoracic trauma. Method: Case-control study of 295 patients (123 cases and 172 controls) treated between January 2015 and December 2019 at the Trujillo Regional Teaching Hospital and the Belén Hospital in Trujillo. The variables exposed were age, sex, type of trauma, hemothorax, pneumothorax, pulmonary contusion and the Thoracic Trauma Severity Score (TTSS). The cases were patients with an unfavorable clinical evolution that included major surgery, admission to the Intensive Care Unit, intubation, mortality and prolonged hospital stay. Results: The odds ratio obtained was 0.69 [0.35–1.32] for age, 1.02 [0.56 – 1.88] for sex, 1.17 [0.68 – 1.99] for trauma type, 4.02 [2.38 – 6.78] for hemothorax, 2.14 [1.29 – 3.56] for pneumothorax and 4.99 [2.92 – 8.53] for pulmonary contusion. The threshold for TSS was estimated, where a cut-off point greater than or equal to 7 was obtained with an area under the curve of 0.77 [95% CI, 0.71 – 0.83]. Conclusions: Hemothorax, pneumothorax, pulmonary contusion, and TTSS with a score of 7 points or more are factors related to an unfavorable clinical evolution.
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Keywords
Lesiones Torácicas, Pronóstico, Resultados Clínicos