Fatores associados ao desfecho em vítimas de trauma submetidos a procedimentos cirúrgicos de urgência e emergência em um hospital de ensino entre 2021 e 2023 – um estudo retrospectivo

Abstract

INTRODUCTION: Urgent and emergency surgeries represent a relevant predictor of mortality, due to the logistical impact and professional demand in the surgical center. Traumatic injuries are the main cause of morbidity and mortality in the first half of life. Among these, abdominal injuries occur in up to one third of trauma patients, covering a wide spectrum of mechanisms and types of injury. It is estimated that 10% of trauma-related deaths are attributed to abdominal injuries. The standard treatment for abdominal trauma is exploratory laparotomy, especially when the patient presents to the emergency room with hemodynamic instability, physical signs of acute peritonitis or diffuse abdominal tenderness, regardless of the extent and location of the penetrating wound. OBJECTIVES: to outline the factors involved in the outcomes of trauma patients undergoing urgent and emergency surgical procedures in the abdominal cavity. METHODOLOGY: This is a retrospective, cross-sectional, descriptive and quantitative study. This study is derived from the umbrella project: “Epidemiology and Factors Associated with Outcome in Patients Undergoing Urgent and Emergency Surgical Procedures – a Retrospective Study”. Carried out at the Lagarto University Hospital from 2021 to 2023. Qualitative variables were described using absolute and relative frequencies. For continuous and discrete quantitative variables, the mean, standard deviation, median, and their variation were calculated. To identify associations between the variables of interest and outcomes, comparisons were made between groups of individuals who did or did not progress to death and between those who progressed to hospital discharge. In these comparisons, Pearson's Chi Square or Fisher's Exact tests were performed. RESULTS: 34 medical records were analyzed. 5 (14.7%) died. The presence of complications was associated with death (p-value = 0.007) CONCLUSION: The occurrence of complications was associated with death. Clinical complications were more prevalent in patients with end-organ dysfunction, especially renal dysfunction. The small sample size may have reduced the statistical power to detect changes.