Abstract：
OBJECTIVE:To identify factors related to mortality in adult trauma patients, analyzing the clinical, epidemiological and therapeutic characteristics at the pre-hospital levels, in the Emergency Care Department and in Intensive Care. DESIGN:A retrospective, longitudinal descriptive study was carried out. Statistical analysis was performed using SPSS, MultBiplot and data mining methodology. SETTING:Adult multiple trauma patients admitted to the Salamanca Hospital Complex (Spain) from 2006 to 2011. MAIN VARIABLES OF INTEREST:Demographic variables, clinical, therapeutic and analytical data from the injury site to ICU admission. Evolution from ICU admission to hospital discharge. RESULTS:A total of 497 patients with a median age of 45.5 years were included. Males predominated (76.7%). The main causes of injury were traffic accidents (56.1%), precipitation (18.4%) and falls (11%). The factors with the strongest association to increased mortality risk (P<.05) were age > 65 years (OR 3.15), head injuries (OR 3.1), pupillary abnormalities (OR 113.88), level of consciousness according to the Glasgow Coma Scale ≤ 8 (OR 12.97), and serum lactate levels > 4 mmol/L (OR 9.7). CONCLUSIONS:The main risk factors identified in relation to the prognosis of trauma patients are referred to the presence of head injuries. Less widely known statistical techniques such as data mining or MultBiplot also underscore the importance of other factors such as lactate concentration. Trauma registries help assess the healthcare provided, with a view to adopting measures for improvement.
journal_name
Med Intensivajournal_title
Medicina intensivaauthors
González-Robledo J,Martín-González F,Moreno-García M,Sánchez-Barba M,Sánchez-Hernández Fdoi
10.1016/j.medin.2014.06.004subject
Has Abstractpub_date
2015-10-01 00:00:00pages
412-21issue
7eissn
0210-5691issn
1578-6749pii
S0210-5691(14)00151-Xjournal_volume
39pub_type
杂志文章abstract：:Extracorporeal membrane oxygenation (ECMO) support is indicated in patients who are refractory to treatment, those with cardiogenic shock or respiratory failure and those with exacerbations eligible for heart and lung transplantation. Physician experience and quantity of necessary resources are reasons why regionaliza...
journal_title：Medicina intensiva
pub_type： 杂志文章,评审
doi：10.1016/j.medin.2018.01.004
更新日期：2019-03-01 00:00:00
abstract：:Immunosuppression in transplantation has experienced changes in recent years as a result of the introduction of new drugs that act upon the different pathways of the host immune response with the purpose of securing more individualized immune suppression, with fewer side effects. Although following in the steps of oth...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2012.05.011
更新日期：2013-01-01 00:00:00
abstract：:Severe acute pancreatitis (SAP) causes local and systemic complications leading to high catabolic, hypermetabolic and hyperdynamic stress states with marked morbidity and mortality. In the last decade, nutritional support has become a key element in the treatment of SAP. Thus, specialized nutrition is indicated from a...
journal_title：Medicina intensiva
pub_type： 共识发展会议,杂志文章,实务指引
doi：10.1016/S0210-5691(11)70007-9
更新日期：2011-11-01 00:00:00
abstract：:Thoracic surgery has undergone significant advances in recent years related to anesthetic and surgical techniques and the prevention and management of complications related to the procedure. This has allowed improvements in patient clinical outcomes in surgeries of this kind. Despite the above, thoracic surgery, espec...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2019.10.012
更新日期：2020-04-01 00:00:00
abstract：:BD was diagnosed by clinical examination, electroencephalogram (EEG), Transcranial Doppler (TCD) and multislice CT of 64 detectors. Initially, a brain perfusion study was performed. This was followed by supra-aortic trunk and brain artery angiography with acquisition of images using 0.5 mm slices, from the origin of t...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/s0210-5691(07)74833-7
更新日期：2007-08-01 00:00:00
abstract：OBJECTIVE:To analyze the management and progression of the critical trauma patient. DESIGN:A retrospective, descriptive analysis. SETTING:The ICU in the province of Toledo. PATIENTS:All patients with traumatic injury admitted during the 2001-2007 period (7 years). MAIN VARIABLES OF INTEREST:These include the variab...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2010.02.002
更新日期：2010-08-01 00:00:00
abstract：OBJECTIVES:To identify the organs most susceptible to develop multiorgan dysfunction syndrome (MODS) in patients with sepsis due to secondary peritonitis, and to determine the outcome and mortality predicting utility of the SOFA (Sequential Organ Failure Assessment) system. DESIGN:A prospective, observational cohort s...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2012.07.010
更新日期：2013-10-01 00:00:00
abstract：:Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus, that was first recognized in Wuhan, China, in December 2019. Currently, the World Health Organization (WHO) has defined the infection as a global pandemic and there is a health and social emergency for the mana...
journal_title：Medicina intensiva
pub_type： 共识发展会议,杂志文章,实务指引
doi：10.1016/j.medin.2020.03.005
更新日期：2020-10-01 00:00:00
abstract：OBJECTIVE:To assess the impact of gender upon the prognosis and medical care in a regional acute ST-elevation myocardial infarction management network. DESIGN:An observational study was made of consecutive patients entered in a prospective database. SCOPE:The Catalan acute ST-elevation myocardial infarction managemen...
journal_title：Medicina intensiva
pub_type： 杂志文章,多中心研究
doi：10.1016/j.medin.2016.06.008
更新日期：2017-03-01 00:00:00
abstract：:Tuberculosis miliar is a very rare complication of bacillus Calmette-Guérin (BCG) immunotherapy that is associated to high mortality. Thus, early diagnosis and treatment is essential. At present, there is a polymerase chain reaction technique (PCR) which is a rapid diagnostic method with elevated sensitivity. Treatmen...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/s0210-5691(06)74485-0
更新日期：2006-04-01 00:00:00
abstract：OBJECTIVES:1) To assess the prevalence of pain during nursing care procedures, and 2) to evaluate the usefulness of certain vital signs and the bispectral index (BIS) in detecting pain. METHODS:A prospective, observational analytical study was made of procedures (endotracheal aspiration and mobilization with turning) ...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2015.03.004
更新日期：2016-03-01 00:00:00
abstract：:There is a direct correlation between the development of the multiple organ dysfunction syndrome (MODS) and the elevated mortality associated with sepsis. The mechanisms responsible for MODS development are being studied, however, the main efforts regarding MODS evaluation have focused on oxygen delivery optimization ...
journal_title：Medicina intensiva
pub_type： 杂志文章,评审
doi：10.1016/j.medin.2008.10.002
更新日期：2009-11-01 00:00:00
abstract：:These recommendations are designed to be of assistance to doctors in ICUs when making first evaluations of these patients. They are mainly intended to assist with early diagnosis, risk stratification and initial treatment. The need for individualised treatment is at present one of the main objectives in the management...
journal_title：Medicina intensiva
pub_type： 共识发展会议,杂志文章,实务指引,评审
doi：10.1016/j.medin.2009.07.010
更新日期：2010-01-01 00:00:00
abstract：INTRODUCTION:Hemodynamic parameters such as the global end-diastolic volume index (GEDVI) and extravascular lung water index (EVLWI), derived by transpulmonary thermodilution, have gained increasing interest for guiding fluid therapy in critically ill patients. The proposed normal values (680-800ml/m(2) for GEDVI and 3...
journal_title：Medicina intensiva
pub_type： 杂志文章,meta分析
doi：10.1016/j.medin.2011.11.014
更新日期：2012-10-01 00:00:00
abstract：:The benefit of enteral nutrition in critically ill patients has been demonstrated by several studies, especially when it is started early, in the first 24-48h of stay in the Intensive Care Unit, and this practice is currently advised by the main clinical guidelines. The start of enteral nutrition is controversial in p...
journal_title：Medicina intensiva
pub_type： 杂志文章,评审
doi：10.1016/j.medin.2014.04.002
更新日期：2015-01-01 00:00:00
abstract：OBJECTIVE:To analyze the efficacy of negative fluid balance in hypoxemic patients with an elevated extravascular lung water index (EVLWI). DESIGN:A retrospective observational study was made. SETTING:Intensive Care Unit of Virgen de las Nieves Hospital (Spain). PARTICIPANTS:Forty-four patients participated in the st...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2014.07.008
更新日期：2015-08-01 00:00:00
abstract：:Electrical impedance tomography has been described as a new method of monitoring critically ill patients on mechanical ventilation. It has recently gained special interest because of its applicability for monitoring ventilation and pulmonary perfusion. Its bedside and continuous implementation, and the fact that it is...
journal_title：Medicina intensiva
pub_type： 杂志文章,评审
doi：10.1016/j.medin.2011.05.005
更新日期：2011-11-01 00:00:00
abstract：PURPOSE:Streptococcus pneumoniae and Neisseria meningitidis are major causes of severe invasive bacterial infections in some individuals. Apparently the genetic is a major susceptibility determinant to these infectious diseases. We study if the functional polymorphisms within genes of the innate immune system (TLR2-TLR...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2013.08.006
更新日期：2014-08-01 00:00:00
abstract：INTRODUCTION:Real body weight and height are essential data to be obtained in all critically ill patients (CIP), due to their influence in the designing of therapies and monitoring. Visual estimation is a very inaccurate practice. No precise descriptions of anthropometric measurements among CIP are available in the cli...
journal_title：Medicina intensiva
pub_type： 杂志文章,多中心研究
doi：10.1016/j.medin.2017.09.008
更新日期：2018-01-01 00:00:00
abstract：OBJECTIVE:To determine whether extension to holidays and weekends of the protocol for the early proactive detection of severity in hospital ("ICU without walls" project) results in decreased mortality among patients admitted to the ICU during those days. DESIGN:A quasi-experimental before-after study was carried out. ...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2015.09.001
更新日期：2016-06-01 00:00:00
abstract：OBJECTIVE:To analyze the current evidence on glycemic control with insulin therapy in the critically ill. RECENT FINDINGS:Stress hyperglycemia in critically ill patients has been associated with increased morbidity and mortality. Furthermore, current evidence suggests that glucose variability has a predictive value fo...
journal_title：Medicina intensiva
pub_type： 杂志文章,评审
doi：10.1016/j.medin.2009.10.003
更新日期：2010-05-01 00:00:00
abstract：:Technology and insertion techniques for cardiac temporary internal pacing have experienced a remarkable development over the last few years. Despite this fact, the procedure continues to have potentially fatal associated complications. Temporary internal pacing is indicated for the treatment of bradyarrhythmias or tac...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2014.02.006
更新日期：2014-12-01 00:00:00
abstract：OBJECTIVE:To assess the incidence and prognostic value of acute renal function deterioration (ARFD) in patients with acute heart disease. SETTING:Coronary Care Unit in a tertiary university hospital. DESIGN:Retrospective study. PARTICIPANTS:One hundred consecutive patients admitted during 2004. INTERVENTIONS:No ran...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/s0210-5691(08)70932-x
更新日期：2008-05-01 00:00:00
abstract：OBJECTIVE:An evaluation is made of the hospital mortality predicting capacity of the main predictive scoring systems. DESIGN:A 2-year retrospective cohort study was carried out. SETTING:A third level ICU with surgical and medical patients. PATIENTS:All patients with multiorgan failure during the first day in the ICU...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2015.03.005
更新日期：2016-04-01 00:00:00
abstract：OBJECTIVE:To determine the results of the implementation of a protocol in an intensive care unit (ICU) referred to critically ill patients requiring a prolonged artificial airway. DESIGN:A prospective, observational cohort study was carried out. INTERVENTION:Management strategies were established on the airway by end...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2012.07.003
更新日期：2013-08-01 00:00:00
abstract：:With the aim of analyzing the current state of the educational objectives in the training of medical residents in solid organ transplantation (SOT), we conducted a review of the status of the official programs of the specialities involved in SOT, focusing particularly on lung transplantation. A survey of medical resid...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2012.03.012
更新日期：2012-11-01 00:00:00
abstract：OBJECTIVE:to document possible complications related to the location of central venous catheter (CVC) tip in the right atrium (RA) in two medical-surgical intensive care units (ICU). DESIGN:An observational, retrospective study of critically ill patients. SETTING:two medical-surgical ICUs. PATIENTS:adult patients in...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2010.07.003
更新日期：2010-12-01 00:00:00
abstract：OBJECTIVE:To compare the results of quality monitoring after the implementation of improvement strategies in the respiratory intensive care unit (RICU). DESIGN:A prospective, comparative, longitudinal and interventional study was carried out. SETTING:The RICU of Hospital General de México (Mexico). PATIENTS:All pati...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2014.01.006
更新日期：2015-04-01 00:00:00
abstract：:The current COVID-19 pandemic has rendered up to 15% of patients under mechanical ventilation. Because the subsequent tracheotomy is a frequent procedure, the three societies mostly involved (SEMICYUC, SEDAR and SEORL-CCC) have setup a consensus paper that offers an overview about indications and contraindications of ...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2020.05.002
更新日期：2020-11-01 00:00:00
abstract：:Most of transplanted organs are obtained from brain death (BD) donors. In neurocritical patients with catastrophic injuries and decompressive craniectomy (DC), which show a dreadful development in spite of this treatment, DC could be a futile tool to avoid natural progress to BD. We propose if cranial compressive band...
journal_title：Medicina intensiva
pub_type： 杂志文章
doi：10.1016/j.medin.2012.12.008
更新日期：2013-04-01 00:00:00
