[Trauma of pancreas: predictor's factors of morbidity and mortality related to trauma index].
BACKGROUND
Although relatively uncommon, traumatic pancreatic injury is associated with significant morbidity and mortality.


OBJECTIVE
To define the predictors' factors of increase in the morbidity and mortality in patients with pancreatic trauma.


METHODS
In this casuistic 131 patients were studied, since January 1994 through December 2007, with theirs epidemiological, physiological and anatomic parameters compared and the analysis of the predictive values for the occurrence of bad evolution, with an appropriate statistical study.


RESULTS
Penetrating trauma occurred in 64% and blunt trauma in 36%, and 91.6% was male. The mean age was 29,8 years. The global morbidity in this series was 64.9% with 29% prevalence of pancreas related complications, such as pancreatic fistula and bleeding occurrence. The overall mortality was 27.5% and occurred by hemorrhagic shock and multiple organs and system failed.


CONCLUSIONS
Higher morbidity and mortality was related with complex injuries of the pancreas (grade IV and V), but morbidity and mortality in the group of injuries grade I and II are not minimal in patients with changed values of revised trauma score and high values of injury severity score and abdominal trauma index. Systolic blood pressure lower 90 mm Hg, changed values of revised trauma score index, values of injury severity score higher 15 and values of abdominal trauma index higher 25 are predictive factors of morbidity. Changed values of revised trauma score, values of injury severity score or abdominal trauma index higher 25, systolic blood pressure are predictive factors of mortality in patients with pancreatic trauma. Low values of TRISS are predictive of higher morbidity and mortality, but high values of TRISS are not predictives of satisfactory evolution.
Silveira
Henrique José Virgili
HJ
Trabalho realizado na Disciplina de Cirurgia do Trauma, Departamento de Cirurgia da Faculdade de Ciências Médicas da Universidade Estadual de Campinas (UNICAMP), Campinas, SP. henriquejvs@gmail.com
Mantovani
Mario
M
Fraga
Gustavo Pereira
GP
D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000293:injuries*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016019:Survival Analysis; D014949:Wounds, Nonpenetrating / Q000209:etiology / Q000401:mortality* / Q000601:surgery; D014950:Wounds, Penetrating / Q000209:etiology / Q000401:mortality* / Q000601:surgery; D055815:Young Adult
Trauma do pâncreas: fatores preditivos de morbidade e mortalidade relacionados a índices de trauma.