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Trauma quality indicators: a way to identify attention points in the treatment of elderly trauma patients.
Lucarelli-Antunes, Pedro DE Souza; Pivetta, Luca Giovanni Antonio; Parreira, JosÉ Gustavo; Assef, JosÉ CÉsar.
Afiliación
  • Lucarelli-Antunes PS; Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brazil.
  • Pivetta LGA; Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
  • Parreira JG; Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brazil.
  • Assef JC; Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
Rev Col Bras Cir ; 47: e20202533, 2020.
Article en Pt, En | MEDLINE | ID: mdl-32844914
PURPOSE: to trauma quality indicators as a tool to identify opportunities of improvement in elderly trauma patient's' treatment. METHODS: prospective analysis of data collected between 2014-2015, and stored in the iTreg software (by Ecossistemas). Trauma victims, aged older than 60 years and trauma quality indicators were assessed, based on those supported by SBAIT in 2013: (F1) Acute subdural hematoma drainage after 4 hours from admission, in patients with GCS<9; (F2) emergency room transference without definitive airway and GCS <9; (F3) Re-intubation within 48 hours from extubation; (F4) Admission-laparotomy time greater than 60 min. in hemodynamically uinstable patients with abdominal bleeding; (F5) Unprogrammed reoperation; (F6) Laparotomy after 4 hours from admission; (F7) Unfixed femur diaphyseal fracture; (F8) Non-operative treatment for abdominal gunshot; (F9) Admission-tibial exposure fracture treatment time greater than 6 hours; (F10) Surgery after 24 from admission. The indicators, treatments, adverse effects and deaths were analyzed, using the SPSS software, and the chi-squared and Fisher tests were used to calculate the statistical relevance. RESULTS: from the 92 cases, 36 (39,1%) had complications and 15 (16,3%) died. The adequate use of quality indicator's were substantially different among those who survived (was of 12%) compared to those who died (55,6%). The incidence of complications was of 77,8% (7/9) in patients with compromised indicators and 34,9% (28/83) in those without (p=0.017). CONCLUSIONS: trauma quality indicators are directly related with the occurrence of complications and deaths, in elderly trauma patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Centros Traumatológicos / Heridas y Lesiones / Hematoma Subdural Agudo / Extubación Traqueal / Laparotomía Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En / Pt Revista: Rev Col Bras Cir Año: 2020 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Brasil
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Centros Traumatológicos / Heridas y Lesiones / Hematoma Subdural Agudo / Extubación Traqueal / Laparotomía Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En / Pt Revista: Rev Col Bras Cir Año: 2020 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Brasil