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- Title
Factores asociados con la mortalidad en pacientes traumáticos con puntuación de 3 en la escala de coma de Glasgow y midriasis bilateral arreactiva.
- Authors
Chico-Fernández, Mario; Barea-Mendoza, Jesús Abelardo; Servià-Goixart, Luis; Ormazabal-Zabala, Txoan; Quintana-Díaz, Manuel; González-Robledo, Javier; Iglesias-Santiago, Alberto; Sánchez-Arguiano, María Juncal; Pérez-Bárcena, Jon; Llompart-Pou, Juan Antonio
- Abstract
Objectives. To compare patients with a Glasgow Coma Scale (GCS) score of 3 stratified according to pupillary reaction and to explore factors associated with in-hospital death in those with bilateral fixed dilated pupils. Methods. Prospective, observational, multicenter study. We included all patients with trauma and GCS scores of 3 admitted to the intensive care unit from March 2015 to December 2019. Factors associated with in-hospital mortality in the patients with bilateral dilated pupils were explored using multiple regression analysis. Results. Of the 933 patients included, 454 (48.7%) had responsive pupils, 201 (21.5%) had a single fixed dilated pupil, and 278 (29.8%) had bilateral dilation. Hospital mortality was high in all 3 groups: 32.5% in those with normal responsive pupils, 54.6% in those with a single unreactive pupil, and 91.0% in those with bilateral dilation. Factors significantly associated with in-hospital death were age, a score of 3 or more on the Abbreviated Injury Scale for the head, and shock or refractory shock. Types I or II diffuse lesions and evacuated mass lesions were protective in patients with GCS scores of 3 and bilateral dilated pupils. Twelve of the 26 patients (46.1%) with bilateral dilated pupils and GCS scores of 3 had GCS scores of 14 or 15 on discharge from the hospital. Conclusions. The in-hospital mortality was 91% in this study of trauma patients with GCS scores of 3 and bilateral dilated pupils. Factors significantly associated with in-hospital death were age, a score of 3 or more on the Abbreviated Injury Scale for the head, and shock or refractory shock. Types I or II diffuse lesions and evacuated mass lesions were protective in patients with GCS scores of 3 and bilateral dilated pupils.
- Subjects
RESEARCH; INTENSIVE care units; SCIENTIFIC observation; MULTIPLE regression analysis; AGE distribution; PUPIL (Eye); MEDICAL cooperation; SHOCK (Pathology); PATIENTS; HOSPITAL mortality; DESCRIPTIVE statistics; EMERGENCY medical services; GLASGOW Coma Scale; WOUNDS &; injuries; LONGITUDINAL method; DISCHARGE planning
- Publication
Emergencias, 2021, Vol 33, Issue 2, p121
- ISSN
1137-6821
- Publication type
Article