Surgical treatment in hepatic trauma: factors associated with hospitalization time

Abstract

Objective: the aim of this study was to identify associated factors with the increased length of hospital stay for patients undergoing surgical treatment for liver trauma, and predictors of mortality as well as the epidemiology of this trauma. Methods: retrospective study of 191 patients admitted to the Cajuru University Hospital, a reference in the treatment of multiple trauma patients, between 2010 and 2017, with epidemiological, clinicopathological and therapeutic variables analyzed using the STATA version 15.0 program. Results: most of the included patients were men with a mean age of 29 years. Firearm injury represents the most common trauma mechanism. The right hepatic lobe was injured in 51.2% of the cases, and hepatorraphy was the most commonly used surgical correction. The length of hospital stay was an average of 11 (0-78) days and the length of stay in the intensive care unit was 5 (0-52) days. Predictors for longer hospital stay were the mechanisms of trauma, hemodynamic instability at admission, number of associated injuries, degree of liver damage and affected lobe, used surgical technique, presence of complications, need for reoperation and other surgical procedures. Mortality rate was 22.7%. Conclusions: the study corroborated the epidemiology reported by the literature. Greater severity of liver trauma and associated injuries characterize patients undergoing surgical treatment, who have increased hospital stay due to the penetrating trauma, hemodynamic instability, hepatic packaging, complications and reoperations.

Trauma hepático contuso por colisão moto-moto com realização de cirurgia controle de danos

“…A gestão das lesões traumáticas hepáticas contusas apresenta uma variedade de desafios clínicos, com a decisão sobre a intervenção cirúrgica sendo influenciada pela estabilidade hemodinâmica do paciente e pela gravidade da lesão. Em muitos casos, especialmente quando há instabilidade hemodinâmica ou falha do tratamento não operatório, a cirurgia torna-se necessária, destacando-se a importância da abordagem de Controle de Danos (Damage Control Surgery) (Trintinalha et al, 2021;Neves et al, 2016).…”

Cirurgia De Controle De Danos Em Pacientes Vítimas De Trauma Hepático : Uma Revisão Literária

“…Além disso, fatores como a intensidade da perda sanguínea, lesões associadas abdominais ou extra-abdominais e o uso de hemoderivados também influenciam na morbidade e mortalidade desses pacientes, exigindo um conhecimento aprofundado dessas variáveis. 7 Os princípios da cirurgia de controle de danos envolvem uma abordagem cirúrgica inicial para controlar o sangramento e a contaminação abdominal, bem como a ressuscitação simultânea do paciente até que a fisiologia esteja estabilizada o suficiente para a intervenção cirúrgica definitiva. 2 Ao longo do tempo, o tratamento cirúrgico de pacientes com hemorragia exsanguinante passou por transformações significativas.…”