Vascular trauma in the Amazon - the challenge of great distances

Revista do Colégio Brasileiro de Cirurgiões

Adenauer Marinho De Oliveira GÓes Junior¹  Allan Dias Vasconcelos Rodrigues¹  FÁbio Brito Braga¹  Mariseth Carvalho De Andrade¹  Simone De Campos Vieira Abib¹ 

关键词: External Causes;    Wounds and Injuries;    Vascular System Injuries;    Blood vessels;    Ulnar Artery;    Causas Externas;    Ferimentos e Lesões;    Lesões do Sistema Vascular;    Vasos Sanguíneos;    Artéria Ulnar;   

DOI  :  10.1590/0100-69912015004009

来源: SciELO

【 摘 要 】

ABSTRACTObjective:to evaluate the incidence of unfavorable outcomes in vascular trauma patients and their possible correlation to the distance between the city where the injury was sustained and the hospital where the patient received definitive treatment.Methods:descriptive and retrospective study. Data were collected from medical records of patients submitted to surgical procedures for arterial or venous injuries from February 2011 to February 2013 at the only trauma center providing vascular surgery in a vast area of the Amazon region. Trauma date, patient gender and age, mechanism and anatomic topography of injury, surgical management, need for surgical re-intervention, hospitalization period, postoperative complications, mortality and limb amputation rates were analyzed. The incidence of unfavorable outcomes was assessed according to the distance between the city where the vascular injury was sustained and the trauma center.Results: One hundred seventy-three patients with 255 vascular injuries were analyzed; 95.95% were male (p<0.05), mean age of 28.92 years; 47.4% were caused by firearm projectiles (p<0.05); topographic distribution: 45.66% lower limbs (p<0.05), 37.57% upper limbs, 6.94% abdominal, 5.2% thoracic and 4.62% were cervical vascular injuries; 51.42% of patients required hospitalization for seven days or less (p<0.05); limb amputation was necessary in 15.6% and the overall mortality was 6.36%.Conclusion:distances greater than 200Km were associated to longer hospitalization period; distances greater than 300Km were associated to increased limb amputation probability; severe vascular trauma have an increased death probability when patients need to travel more than 200Km for surgical treatment.

【 授权许可】

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