Factores de mal pronóstico de trauma craneoencefalico severo
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2022
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
Introducción: El trauma craneoencefálico es una patología clínico-quirúrgica que se caracteriza por un daño cerebral posterior a un suceso traumático a nivel de cráneo y encéfalo. El mismo ocupa a nivel mundial el tercer lugar como principal causa de mortalidad y en el Ecuador ocupa el cuarto lugar de mortalidad según los datos proporcionados por el Instituto Nacional de Estadística y Censos. Para clasificar la gravedad del traumatismo craneoencefálico la herramienta más utilizada es la escala de Coma de Glasgow.
Materiales y métodos: Se realizo un estudio cuantitativo, observacional, transversal, retrospectivo y analítico de 150 pacientes con diagnóstico de traumatismo craneoencefálico severo en el Hospital de Especialidades Dr. Abel Gilbert Pontón durante el periodo de enero 2018- julio 2019.
Resultados: Se obtuvo que el 64% (n=79) de los pacientes con traumatismo craneoencefálico severo fueron de género masculino mayores a 50 años con 60% c, siendo el mecanismo de trauma predominante los accidentes por motocicleta en un 78% (n=53). El puntaje de la escala de Glasgow que se presentó con mayor frecuencia fue de 3 puntos con 100% (n=25). Entre los antecedentes patológicos que más se presentaron fue la Diabetes mellitus más la hipertensión arterial 93% (n=26).
Conclusiones: Se concluyo que los factores que conllevan a mal pronóstico en los pacientes con traumatismo craneoencefálico severo posterior a la intervención neuroquirúrgica fue una puntuación en la escala de Glasgow 3, grado VI en la escala tomográfica de Marshall y las diferentes complicaciones que se pueden presentar, siendo la que peor pronóstico presenta la complicación renal.
Introduction: Cranioencephalic trauma is a clinical-surgical pathology that is characterized by brain damage after a traumatic event at the level of the skull and brain. It occupies the third place worldwide as the main cause of mortality and in Ecuador it occupies the fourth place of mortality according to data provided by the National Institute of Statistics and Censuses. To classify the severity of traumatic brain injury, the most commonly used tool is the Glasgow Coma scale. Materials and methods: A quantitative, observational, cross-sectional, retrospective and analytical study of 150 patients diagnosed with severe head trauma was carried out at the Dr. Abel Gilbert Pontón Specialty Hospital during the period from January 2018 to July 2019. Results: It was obtained that 64% (n=79) of the patients with severe traumatic brain injury were male over 50 years of age with 60% c, with the predominant trauma mechanism being motorcycle accidents in 78% (n=53). The most frequently presented Glasgow scale score was 3 points with 100% (n=25). Among the pathological antecedents that occurred the most was Diabetes mellitus plus arterial hypertension 93% (n=26). Conclusions: It was concluded that the factors that lead to poor prognosis in patients with severe head trauma after neurosurgical intervention was a score on the Glasgow 3 scale, grade VI on the Marshall tomographic scale and the different complications that may occur, being the one with the worst prognosis presented by the renal complication
Introduction: Cranioencephalic trauma is a clinical-surgical pathology that is characterized by brain damage after a traumatic event at the level of the skull and brain. It occupies the third place worldwide as the main cause of mortality and in Ecuador it occupies the fourth place of mortality according to data provided by the National Institute of Statistics and Censuses. To classify the severity of traumatic brain injury, the most commonly used tool is the Glasgow Coma scale. Materials and methods: A quantitative, observational, cross-sectional, retrospective and analytical study of 150 patients diagnosed with severe head trauma was carried out at the Dr. Abel Gilbert Pontón Specialty Hospital during the period from January 2018 to July 2019. Results: It was obtained that 64% (n=79) of the patients with severe traumatic brain injury were male over 50 years of age with 60% c, with the predominant trauma mechanism being motorcycle accidents in 78% (n=53). The most frequently presented Glasgow scale score was 3 points with 100% (n=25). Among the pathological antecedents that occurred the most was Diabetes mellitus plus arterial hypertension 93% (n=26). Conclusions: It was concluded that the factors that lead to poor prognosis in patients with severe head trauma after neurosurgical intervention was a score on the Glasgow 3 scale, grade VI on the Marshall tomographic scale and the different complications that may occur, being the one with the worst prognosis presented by the renal complication
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Lesiones traumáticas del encéfalo, Mortalidad, Estudio retrospectivo, Diabetes mellitus, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador