Trauma hepático: epidemiologia de cinco anos em um serviço de emergência

Stalhschmidt, Carla Martinez Menini; Formighieri, Beatriz; Marcon, Débora Majszak; Takejima, Aline; Soares, Luis Guilherme Sanches

doi:10.1590/s0100-69912008000400004

Cited by 7 publications

(13 citation statements)

References 27 publications

(28 reference statements)

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“…O abdome é frequentemente acometido nos traumatismos, sendo que o fígado, devido ao seu tamanho e sítio anatômico, é um dos órgãos intraabdominais mais afetados, tanto por ferimentos penetrantes como por lesões contusas [3,[8][9][10]. …”

Section: Discussionunclassified

“…Estudos realizados na Europa geralmente mostram índices de trauma contuso superiores aos índices de trauma penetrante, enquanto que estudos em países em desenvolvimento observam o contrário [2,3]. Um levantamento populacional de todos os casos de trauma hepático identificados na Escócia entre 1992 e 2002, em que foram avaliados 783 casos, mostrou que o trauma contuso ocorreu em 69%, sendo a maioria deles por acidentes rodoviários [11].…”

Section: /6unclassified

“…Por outro lado, quedas da própria altura podem ser importante causa de trauma hepático em idosos, possuindo outros mecanismos associados [3,4].…”

Section: /6unclassified

“…Além disso, outros estudos também mostram que lesões associadas são muito comuns no trauma hepático, e evidenciam números que variam de 75% até 90% [1,3,8,9]. Identificou-se nesse trabalho que a maior parte dos traumas hepáticos (61%) apresentava-se em vítimas politraumatizadas.…”

Section: /6unclassified

“…O fígado está acometido em aproximadamente 5% das admissões por trauma em serviço de urgência, correspondendo a um dos órgãos mais afetados, principalmente devido ao seu tamanho e sítio anatômico, apresentando o trauma abdominal fechado como o principal mecanismo de lesão [2][3][4].…”

Section: Introductionunclassified

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Trauma hepático: prevalência e características epidemiológicas de vítimas encaminhadas ao Instituto Médico Legal de Palmas, Tocantins

Castro

Ferreira

Pereira

et al. 2015

Sci Med

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RESUMO ABSTRACTAims: To assess the prevalence and epidemiological characteristics of hepatic trauma in victims referred to the Forensic Department of Palmas, State of Tocantins, Brazil. Methods: A retrospective cross-sectional study was performed with all the victims referred to the Forensic Department of Palmas from January 2006 to December 2010, to investigate violent deaths with severe damage to the liver tissue. The data were collected from the Forensic Department records. The following data were evaluated: sex, age, mechanism of injury (in case of motor vehicle accidents, the type of vehicle involved), types of trauma associated with abdominal trauma, presence of abdominal lesions associated with hepatic injury, the American Association for the Surgery of Trauma Organ Injury Scale, and number of deaths caused directly by hepatic trauma. The statistical analysis included absolute and relative frequencies of the variables. Results: A total of 241 (13.4%) out of 1,796 victims had liver trauma, among whom 85.5% were male and 42.9% belonged to the 21-30 year age group. Motor vehicle accidents were the major cause of trauma in 143 cases, (59.3%), involving mainly motorcycles (53 cases or 37%). Blunt trauma was the most frequent mechanism of injury, having occurred in 179 cases (74.3%). The right lobe was injured in 98 cases (40.7%). A total of 147 victims (61%) had polytrauma. Splenic injury, present in 65 (27%) of the cases, was mostly associated with liver trauma. Liver injury of grade II was detected in 102 cases (42.4%) and was therefore the most prevalent type of damage. Twenty-one (8.7%) deaths were directly related to liver trauma. Conclusions: Blunt injury, caused mainly by motor vehicle accidents (especially with motorcycles), was the most common type of liver trauma observed in violent deaths, according to the records of the Forensic Department of Palmas. Young men of working age were the most frequent victims with liver trauma.KEY WORDS: liver; wounds and injuries; traumatology; epidemiology; accidents, traffic. Scientia Medica Artigo originAlOpen Access 2015;25(1):ID19737 ISSN 1980ISSN -6108 : http://dx.doi.org/10.15448/1980ISSN -6108.2015 Recebido: janeiro,

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Section: Discussionunclassified

Section: /6unclassified

“…Por outro lado, quedas da própria altura podem ser importante causa de trauma hepático em idosos, possuindo outros mecanismos associados [3,4].…”

Section: /6unclassified

Section: Introductionunclassified

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Trauma hepático: prevalência e características epidemiológicas de vítimas encaminhadas ao Instituto Médico Legal de Palmas, Tocantins

Castro

Ferreira

Pereira

et al. 2015

Sci Med

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Epidemiological evaluation of hepatic trauma victims undergoing surgery

Kalil

Amaral

2016

Rev. Col. Bras. Cir.

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Surgical treatment in hepatic trauma: factors associated with hospitalization time

Trintinalha

Cirino

Marcante

et al. 2021

Rev. Col. Bras. Cir.

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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.

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Trauma hepático: epidemiologia de cinco anos em um serviço de emergência

Cited by 7 publications

References 27 publications

Trauma hepático: prevalência e características epidemiológicas de vítimas encaminhadas ao Instituto Médico Legal de Palmas, Tocantins

Trauma hepático: prevalência e características epidemiológicas de vítimas encaminhadas ao Instituto Médico Legal de Palmas, Tocantins

Epidemiological evaluation of hepatic trauma victims undergoing surgery

Surgical treatment in hepatic trauma: factors associated with hospitalization time

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