Sobrevivência após acidentes de trânsito: impacto das variáveis clínicas e pré-hospitalares

Abstract

OBJECTIVE:To assess clinical and prehospital variables associated with survival of motor vehicle crash victims. METHODS:Study carried out in the city of São Paulo (Southeastern Brazil), from 1999 to 2003. Data from 175 patients, who were aged between 12 and 65 years and had been motor vehicle crash victims, were analyzed. KaplanMeier Survival Analysis was used to approach the results at the accident scene with victims scoring <11, according to the Revised Trauma Score. Variables analyzed were: sex, age, injury mechanisms, basic and advanced support procedures, Revised Trauma Score parameters and fl uctuations, time elapsed in the prehospital phase and trauma severity according to the Injury Severity Score and Maximum Abbreviated Injury Scale. RESULTS:Analysis revealed that victims who were less likely to survive during the hospitalization period showed serious lesions in the abdomen, thorax, or lower limbs, with negative fl uctuation of respiratory frequency and Revised Trauma Score in the prehospital phase. In addition, they needed specialized interventions or thoracic compressions. Brain lesions were associated with late death. CONCLUSIONS:Recognition of variables involved in the survival of motor vehicle crash victims may help to determine protocols and to make decisions in order to perform pre-and in-hospital interventions and, consequently, maximize survival.

Nursing diagnoses in trauma victims with fatal outcomes in the emergency scenario

“…In the above study, 175 victims were analyzed and of these, 63 (30.6%) suffered death, with 50.8% up to 6 hours post-event, which shows the importance of developing studies that analyze the post-trauma period. Regarding protective measures, the category of volume replacement was the only one considered effective (16) .…”

“…The risk for shock represented by hypotension/hypovolemia/ hypoxia/increased or decreased heart rate and the trauma itself is a common situation among victims of external causes, especially those with abdominal/ thoracic injuries and with traumatic amputations of lower limbs and exposed fractures (16)(17) .…”

Acidentes de trânsito com adultos e suas consequências após a alta hospitalar

“…No presente estudo, o tempo resposta alcançou uma média de 13,4 (dp= 6,8) minutos, o que está acima dos encontrados em estudos nacionais e internacionais (85,(96)(97)(98) .…”

“…O tempo médio de cena encontrado foi de 13,7 (dp= 6,1) minutos, tempo que se apresentou menor que o encontrado por Malvestio e Souza (96) , que foi de 20,2 min (dp±11,7 min). No entanto, as autoras trabalharam apenas com vítimas atendidas pelo suporte avançado, indicando maior gravidade dos casos, o que explica a diferença encontrada.…”

“…Na mesma cidade, outro estudo realizado em 2008, verificou que 84,6% das vítimas chegaram ao hospital em menos de 60 minutos (96) . Em…”