Medicina intensiva · 2025
Penetrating trauma in Spain: analysis of the Spanish trauma registry (RETRAUCI).
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Gutiérrez-Gutiérrez Judit, Barea-Mendoza Jesús Abelardo, García-Fuentes Carlos, Llompart-Pou Juan Antonio, Guardiola-Grau Begoña, Durán-Suquía Mikel, Ballesteros-Sanz María Ángeles, González-Robledo Javier, Serviá-Goixart Lluís, Méndez-Benegassi Cid Cristina, Toboso Casado Jose Maria, Chico-Fernández Mario, Neurointensivism and Trauma Working Group of the SEMICYUC
Аннотация
OBJECTIVE: To describe the epidemiology of penetrating trauma, mortality associated factors and its management in Spanish intensive care units.
DESIGN: Multicenter, prospective registry. A comparison is established between two cohorts defined by the type of trauma (blunt and penetrating).
PATIENTS: Patients with traumatic injury admitted to the participating ICUs from June 2015 to June 2022.
INTERVENTIONS: None.
MAIN VARIABLE OF INTEREST: Epidemiology, injury pattern, prehospital and hospital care, resource utilization, and clinical outcomes.
RESULTS: 12,806 patients were eligible, of whom 821 (6.4%) suffered penetrating trauma; 418 patients (50.9%) from stab wounds, 93 (11.3%) from gunshot wounds, and 310 (37.8%) from other objects. The most common intent was assault (47.7%). The mean ISS was 15.2 ± 10.6 in penetrating trauma and 19.8 ± 11.9 in blunt trauma (p < 0.001). ICU mortality was 7.8% compared to 11.7% in blunt trauma, with deaths more frequently occurring within the first 24 hours (64% vs. 39%). Factors associated with mortality included female sex, prior use of antithrombotic agents, older age, higher NISS score, and the presence of cranial trauma or shock.
CONCLUSIONS: Penetrating trauma is an emergent pathology in our context with high complexity, highlighting the need for focused study and documentation, protocol development, and resource optimization to provide quality care.
DESIGN: Multicenter, prospective registry. A comparison is established between two cohorts defined by the type of trauma (blunt and penetrating).
PATIENTS: Patients with traumatic injury admitted to the participating ICUs from June 2015 to June 2022.
INTERVENTIONS: None.
MAIN VARIABLE OF INTEREST: Epidemiology, injury pattern, prehospital and hospital care, resource utilization, and clinical outcomes.
RESULTS: 12,806 patients were eligible, of whom 821 (6.4%) suffered penetrating trauma; 418 patients (50.9%) from stab wounds, 93 (11.3%) from gunshot wounds, and 310 (37.8%) from other objects. The most common intent was assault (47.7%). The mean ISS was 15.2 ± 10.6 in penetrating trauma and 19.8 ± 11.9 in blunt trauma (p < 0.001). ICU mortality was 7.8% compared to 11.7% in blunt trauma, with deaths more frequently occurring within the first 24 hours (64% vs. 39%). Factors associated with mortality included female sex, prior use of antithrombotic agents, older age, higher NISS score, and the presence of cranial trauma or shock.
CONCLUSIONS: Penetrating trauma is an emergent pathology in our context with high complexity, highlighting the need for focused study and documentation, protocol development, and resource optimization to provide quality care.