Associated factors with the mortality of traumatized patients: a case-control study

Um Estudo Caso-Controle

Abstract

Introduction: Traumatic injuries currently are the third-leading cause of death in the world, generating an impact on morbidity and mortality, especially in the economically active population.Objective: To evaluate the risk factors for death in trauma in a tertiary hospital.Methods: This was a retrospective case-control study through the analysis of electronic records and files of the initial evaluation of traumatized inpatients at Hospital de Base de São José do Rio Preto, São Paulo State. The study was conduct from January to December 2015.The study sample was composed of two groups.Case group was composed of 21 patients who died. Control group was composed of the 613 patients who survived to the traumatic event.Both groups were compared through general variables, data of the traumatic event, prehospital care, initial hospital evaluation, and outcome of hospitalization. For comparing data between the groups, the Chi-square test.Continuous variables were compared using the independent two-sample Student’s t test. Other results were reported as adjusted odds ratios (ORs) with 95% confidence intervals (CIs).Results: The risk factors for traumatic event mortality identified by the study were: age > 30; trauma due to physical aggression; length of hospital stay > 72 hours; loss of consciousness at the time of the traumatic event; presence of traumatic hypotension in the initial treatment (systolic pressure below 108,7 mmHg); Glasgow Coma Scale ≤ 9, and RTS score below 5,7. Conclusion: The determinant risk factors which represented the highest probability of death after a trauma are induced by physical aggression in a patient aged 30 and over with loss of consciousness after the event, hypotension, low Glasgow Coma Scale score, low RTS in initial care period, in addition to a long-term hospital stay. Thus, despite increasingly consolidated protocols for treating polytrauma patients, there are still limitations in providing better survivability for patients with a worse prognosis.