Retrospective analysis of 103 diaphragmatic injuries in patients operated in a trauma center.

Autor:	Cardoso LF; Hospital Risoleta Tolentino Neves, Belo Horizonte, MG, Brasil., Gonçalves MVC; Hospital Risoleta Tolentino Neves, Belo Horizonte, MG, Brasil., Machado CJ; Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil., Resende V; Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil., Fernandes MP; Hospital Risoleta Tolentino Neves, Belo Horizonte, MG, Brasil., Pastore-Neto M; Hospital Risoleta Tolentino Neves, Belo Horizonte, MG, Brasil., Campanati RG; Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil., Reis GVOP; Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Jazyk:	Portuguese; English
Zdroj:	Revista do Colegio Brasileiro de Cirurgioes [Rev Col Bras Cir] 2017 May-Jun; Vol. 44 (3), pp. 245-251.
DOI:	10.1590/0100-69912017003004
Abstrakt:	Objective:: to analyze the factors associated with death in patients with diaphragmatic injury treated at a trauma reference hospital. Methods:: we conducted a retrospective study of patients with diaphragm injury attended at the Risoleta Tolentino Neves Hospital of the Federal University of Minas Gerais, between January 2010 and December 2014. We used The Collector® database of trauma records (MD, USA). We gathered data on demographics, location of the diaphragmatic lesion, site and number of associated lesions, type of therapeutic approach, complications and Injury Severity Score (ISS). The variable of interest was the occurrence of death. Results:: we identified 103 patients and mortality was 16.5%. Penetrating lesions occurred in 98% of patients. Univariate analysis showed a mortality higher in patients whose treatment was non-operative, without closing of the defect (p=0.023), and lower in patients submitted to diaphragmatic suturing (p<0.001). The increase in the number of lesions was associated with an increase in mortality (p=0.048). In multivariate analysis, ISS>24 (OR=4.0, p=0.029) and diaphragmatic suturing (OR=0.76, p<0.001) were associated with mortality. Conclusion:: The findings indicate that the traumatic rupture of the diaphragm rarely presents as an isolated lesion, being frequently associated with injuries of other organs, especially the liver and hollow viscera. Mortality was higher among those with ISS>24.
Databáze:	MEDLINE
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