Artículos de revistas
Trauma Of Pancreas: Predictor's Factors Of Morbidity And Mortality Related To Trauma Index [trauma Do Pâncreas: Fatores Preditivos De Morbidade E Mortalidade Relacionados A índices De Trauma]
Registro en:
Arquivos De Gastroenterologia. , v. 46, n. 4, p. 270 - 278, 2009.
42803
10.1590/S0004-28032009000400005
2-s2.0-77949785314
Autor
Silveira H.J.V.
Mantovani M.
Fraga G.P.
Institución
Resumen
Context - Although relatively uncommon, traumatic pancreatic injury is associated with significant morbidity and mortality. Objective - To define the predictors' factors of increase in the morbidity and mortality in patients with pancreatic trauma. Method - In this casuistic 131 patients were studied, since January 1994 through December 2007, with theirs epidemiological, physiological and anatomic parameters compared and the analysis of the predictive values for the occurrence of bad evolution, with an appropriate statistical study. Results - Penetrating trauma occurred in 64% and blunt trauma in 36%, and 91.6% was male. The mean age was 29,8 years. The global morbidity in this series was 64.9% with 29% prevalence of pancreas related complications, such as pancreatic fistula and bleeding occurrence. The overall mortality was 27.5% and occurred by hemorrhagic shock and multiple organs and system failed. Conclusions - Higher morbidity and mortality was related with complex injuries of the pancreas (grade IV and V), but morbidity and mortality in the group of injuries grade I and II are not minimal in patients with changed values of revised trauma score and high values of injury severity score and abdominal trauma index. Systolic blood pressure lower 90 mm Hg, changed values of revised trauma score index, values of injury severity score higher 15 and values of abdominal trauma index higher 25 are predictive factors of morbidity. Changed values of revised trauma score, values of injury severity score or abdominal trauma index higher 25, systolic blood pressure are predictive factors of mortality in patients with pancreatic trauma. Low values of TRISS are predictive of higher morbidity and mortality, but high values of TRISS are not predictives of satisfactory evolution. 46 4 270 278 Akhrass, R., Yaffe, M.B., Brandt, C.P., Reigle, M., Fallon, W.F., Malangoni, M.A., Pancreatic trauma: A ten year multi-intitutional experience (1997) Am Surg, 63, pp. 598-604 Asensio, J.A., Demetriades, D., Hanpeter, D.E., Gambaro, E., Chahwan, S., Management of pancreatic injuries (1999) Curr Probl Surg, 36, pp. 325-419 Asensio, J.A., Petrone, P., Roldan, G., Pak, R., Salim, A., Pancreatic and duodenal injuries. Complex and lethal (2002) Scand J Surg, 91, pp. 81-86 Baker, S.P., O'Neill, B., Haddon, W., Long, W.B., The injury severity score: A method for describing patients with multiples injuries and evaluating emergency care (1974) J Trauma, 14, pp. 187-196 Boffard, K.D., Brooks, A.J., Pancreatic trauma-injuries to the pancreas and pancreatic duct (2000) Eur J Surg, 166, pp. 4-12 Borlase, B.C., Moore, E.E., Moore, F.A., The abdominal trauma index - a critical reassessment and validation (1990) J Trauma, 30, pp. 1340-1344 Boyd, C.R., Tolson, M.A., Copes, W.S., Evaluating trauma care: The TRISS method (1987) J Trauma, 27, pp. 370-378 Bradley, E.L., Young, P.R., Chang, M.C., Allen, J.E., Baker, C.C., Meredith, W., Reed, L., Thomason, M., Diagnosis and initial management of blunt pancreatic trauma: Guidelines from a multiinstitution review (1998) Ann Surg, 227, pp. 861-869 Champion, H.R., Sacco, W.J., Coppes, W.S., Gann, D.S., Gennarelli, T.A., Flanagan, M.E., A revision of the trauma score (1989) J Trauma, 29, pp. 623-629 Champion, H.R., Coppes, W.S., Sacco, W.J., Gann, D.S., Flanagan, M.E., The major trauma outcome study: Establishing national norms for trauma care (1990) J Trauma, 30, pp. 1356-1365 Coimbra, R.S.M., Angle, N., Silva, L.E., Hoyt, D.B., Rasslan, S., Índices de trauma: O que são e por que devem ser usados? (1997) Rev Col Bras Cir, 24, pp. 255-263 De Campos, T., Cerqueira, C., Kuryura, L., Parreira, J.G., Soldá, S., Perlingeiro, J.A., Assef, J.C., Rasslan, S., Morbimortality indicators in severe acute pancreatitis. JOP (2008), 9, pp. 690-697Degiannis, E., Glapa, M., Loukogeorgakis, S.P., Smith, M.D., Management of pancreatic trauma (2008) Injury, 39, pp. 21-29 Feliciano, D.V., Martin, T.D., Cruse, P.A., Graham, J.M., Burch, J.M., Mattox, K.L., Bitondo, C.G., Jordan Jr, G.L., Management of combined pancreatoduodenal injuries (1987) Ann Surg, 205, pp. 673-680 Huerta, S., Bui, T., Porral, D., Lush, S., Cinat, M., Predictors of morbidity and mortality in patients with traumatic duodenal injuries (2005) Am Surg, 71, pp. 763-767 Hwang, S.Y., Choi, Y.C., Prognostic determinant in patients with traumatic pancreatic injuries (2008) J Korean Med Sci, 23, pp. 126-130 Jones, W.G., Reilly, D.M., Barie, P.S., Pancreatic injuries. Diagnosis, treatment (1991) AORN J, 53, pp. 917-933 Jurczak, F., Kahn, X., Letessier, E., Plattner, V., Heloury, Y., Le Neel, J.C., Severe pancreaticoduodenal trauma: Review of a serie of 30 patients (1999) Ann Chir, 53, pp. 267-272 Jurkovich, G.J., Carrico, C.J., Pancreatic trauma (1990) Surg Clin N Am, 70, pp. 575-593 Kao, L.S., Bulger, E.M., Parks, D.L., Byrd, G.F., Jurkovich, G.J., Predictors of morbidity after traumatic pancreatic injury (2003) J Trauma, 55, pp. 898-905 Machado, M.A.C., Volpe, P., Souza Jr, A.L., Poggetti, R.S., Branco, P., Birolini, D., Lesões traumáticas do pâncreas: Análise de 65 casos. (1994) Rev Hosp Clin Fac Med S Paulo, 49, pp. 238-242 Moore, E.E., Dunn, E.L., Moore, J.B., Penetrating abdominal trauma index (1981) J Trauma, 21, pp. 439-445 Moore EE, Cogbill TH, Malangoni MA, Jurkovich GJ, Champion HR, Gennarelli TA, McAninch JW, Pachter HL, Shackford SR, Trafton Organ Injury Scaling, II: pancreas, duodenum, small bowel, colon, and rectum. J Trauma. 1990;30:1427-9Patton Jr, J.H., Fabian, T.C., Complex pancreatic injury (1996) Surg Clin North Am, 76, pp. 783-795 Patton Jr, J.H., Lyden, S.P., Croce, M.A., Pritchard, F.E., Minard, G., Kudsk, K.A., Fabian, T.C., Pancreatic trauma: A simplified management guideline (1997) J Trauma, 43, pp. 234-239 Rasslan, S., Casaroli, A.A., Abrantes, W.L., Mantovani, M., Pancreatectomia distal no trauma: Estudo multicêntrico. (1999) Rev Col Bras Cir, 25, pp. 409-414 Subramanian, A., Dente, C.J., Feliciano, D.V., The management of pancreatic trauma in the modern era (2007) Surg Clin N Am, 87, pp. 1515-1532 Vasquez, J.C., Coimbra, R., Hoyt, D.B., Fortlage, D., Management of penetrating pancreatic trauma: An 11 year experience of a level 1 trauma center (2001) Injury, 32, pp. 753-759 Yadav, T.D., Natarajan, S.K., Kishore, V.M., Lyngdoh, S., Wig, J.D., Spleen-preservating distal pancreatectomy for pancreatic trauma: A serie of six cases. JOP (2007), 8, pp. 422-428Young, P.R., Meredith, J.W., Baker, C.C., Pancreatic injuries resulting from penetrating trauma: A multi-institution review (1998) Am Surg, 64, pp. 838-844