Differences in the prognosis among severe trauma and medical patients requiring mechanical ventilation.

作者: Manuel Sánchez-Palacios , Luciano Santana-Cabrera , Alina Uriarte Rodríguez

DOI:

关键词: MedicineOutcome assessmentIcu stayAPACHE IIMechanical ventilationSevere traumaMultivariate analysisEpidemiologyIn patientAnesthesiaPediatrics

摘要: Objetive. To find the differences between prognosis of patients with severe traumatism injury and those who were admitted medical pathology also required mechanical ventilation in our ICU. Patients Method. Retrospective descriptive study a polyvalent ICU third level hospital for period 8 years. Epidemiological variables such as age, sex, average stay, mortality, APACHE II at admission days ventilation, analyzed that received during this period. Results. During 208 732 patients, all them ventilation. are more younger (41.8 vs 55.3 years, p = 0.001) entered state minor severity, according to prognostic index (14.8 17.4, < 0.001), despite which they (9.8 7.8 days, 0.017) had higher stay (11.4 9.4 0.027), although mortality was significantly lower (38.2% 28.2%, 0.005). Multivariate analysis showed independent associated (p 0.0001), 0.0001) type patient 0.016). Conclusions. traumatic require be greater having an increased have better than likely younger.

参考文章(22)
E. Wesley Ely, Arthur P. Wheeler, B. Taylor Thompson, Marek Ancukiewicz, Kenneth P. Steinberg, Gordon R. Bernard, , Recovery Rate and Prognosis in Older Persons Who Develop Acute Lung Injury and the Acute Respiratory Distress Syndrome Annals of Internal Medicine. ,vol. 136, pp. 25- 36 ,(2002) , 10.7326/0003-4819-136-1-200201010-00007
Harmon Davis, Prolonged Mechanically Assisted Ventilation JAMA. ,vol. 243, pp. 43- 45 ,(1980) , 10.1001/JAMA.1980.03300270031025
Antonio Tejada Artigas, Salvador Bello Dronda, Enrique Chacón Vallés, Javier Muñoz Marco, Maria Cruz Villuendas Usón, P. Figueras, F. J. Suarez, A. Hernández, Risk factors for nosocomial pneumonia in critically ill trauma patients Critical Care Medicine. ,vol. 29, pp. 304- 309 ,(2001) , 10.1097/00003246-200102000-00015
Eric M. Mortensen, Christopher M. Coley, Daniel E. Singer, Thomas J. Marrie, D. Scott Obrosky, Wishwa N. Kapoor, Michael J. Fine, Causes of Death for Patients With Community-Acquired Pneumonia Archives of Internal Medicine. ,vol. 162, pp. 1059- 1064 ,(2002) , 10.1001/ARCHINTE.162.9.1059
A F Connors, N V Dawson, C Thomas, F E Harrell, N Desbiens, W J Fulkerson, P Kussin, P Bellamy, L Goldman, W A Knaus, Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments) American Journal of Respiratory and Critical Care Medicine. ,vol. 154, pp. 959- 967 ,(1996) , 10.1164/AJRCCM.154.4.8887592
Martin H. Kollef, Jeana D. O'Brien, Patricia Silver, The Impact of Gender on Outcome From Mechanical Ventilation Chest. ,vol. 111, pp. 434- 441 ,(1997) , 10.1378/CHEST.111.2.434
THOMAS J. MARTIN, JEFFREY D. HOVIS, JOSEPH P. COSTANTINO, MORRIS I. BIERMAN, MICHAEL P. DONAHOE, ROBERT M. ROGERS, JOHN W. KREIT, FRANK C. SCIURBA, RONALD A. STILLER, MARK H. SANDERS, A randomized, prospective evaluation of noninvasive ventilation for acute respiratory failure. American Journal of Respiratory and Critical Care Medicine. ,vol. 161, pp. 807- 813 ,(2000) , 10.1164/AJRCCM.161.3.9808143
Sergey Vasilyev, Robert N. Schaap, JD Mortensen, Hospital Survival Rates of Patients With Acute Respiratory Failure in Modern Respiratory Intensive Care Units Chest. ,vol. 107, pp. 1083- 1088 ,(1995) , 10.1378/CHEST.107.4.1083
R L Doyle, N Szaflarski, G W Modin, J P Wiener-Kronish, M A Matthay, Identification of patients with acute lung injury. Predictors of mortality. American Journal of Respiratory and Critical Care Medicine. ,vol. 152, pp. 1818- 1824 ,(1995) , 10.1164/AJRCCM.152.6.8520742
Adrian W Ong, Laurel A Omert, Diane Vido, Brian M Goodman, Jack Protetch, Aurelio Rodriguez, Elan Jeremitsky, Characteristics and outcomes of trauma patients with ICU lengths of stay 30 days and greater: a seven-year retrospective study Critical Care. ,vol. 13, pp. 1- 9 ,(2009) , 10.1186/CC8054