Doentes com traumatismo crânio-encefálico em coma operados. Factores de morbilidade e mortalidade
Surgically treated severe head injury patients. Factors influencing morbility and mortality
J.L. Reís, C. Pinheiro, V. Martins, E. Carvalho
Serviço de Neurocirugia. Hospital Geral Santo António. Porto. Portugal
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Ortiz de Urbina, M. Santos, J. Samblás, J.M. Delgado, J.C. Bustos, J.A. Gutiérrez-Díaz, I. García-Berrocal, S. Rodríguez, M.C. Rubio, G. Donckaster, F. Sansivirini, F.A. Calvo" "autores" => array:12 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Ortiz de Urbina" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Santos" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Samblás" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Delgado" ] 4 => array:2 [ "nombre" => "J.C." "apellidos" => "Bustos" ] 5 => array:2 [ "nombre" => "J.A." "apellidos" => "Gutiérrez-Díaz" ] 6 => array:2 [ "nombre" => "I." "apellidos" => "García-Berrocal" ] 7 => array:2 [ "nombre" => "S." "apellidos" => "Rodríguez" ] 8 => array:2 [ "nombre" => "M.C." "apellidos" => "Rubio" ] 9 => array:2 [ "nombre" => "G." "apellidos" => "Donckaster" ] 10 => array:2 [ "nombre" => "F." "apellidos" => "Sansivirini" ] 11 => array:2 [ "nombre" => "F.A." "apellidos" => "Calvo" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147399707748?idApp=UINPBA00004B" "url" => "/11301473/0000001000000005/v1_201305151016/S1130147399707748/v1_201305151016/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Doentes com traumatismo crânio-encefálico em coma operados. Factores de morbilidade e mortalidade" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "345" "paginaFinal" => "349" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "J.L. Reís, C. Pinheiro, V. Martins, E. Carvalho" "autores" => array:4 [ 0 => array:2 [ "nombre" => "J.L." "apellidos" => "Reís" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Pinheiro" ] 2 => array:2 [ "nombre" => "V." "apellidos" => "Martins" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Carvalho" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Serviço de Neurocirugia. Hospital Geral Santo António. Porto. Portugal" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Surgically treated severe head injury patients. Factors influencing morbility and mortality" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras chave" "identificador" => "xpalclavsec156762" "palabras" => array:4 [ 0 => "Traumatismo crânio-encefálico grave" 1 => "Coma" 2 => "Tratamento cirúrgico" 3 => "Prognóstico" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec156763" "palabras" => array:4 [ 0 => "Severe head injury" 1 => "Coma" 2 => "Surgical treatment" 3 => "Outcome" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">O objectivo deste trabalho foi avaliar, retrospectivamente, a importância dos vários factores de prognóstico nos doentes traumatizados operados em coma no nosso Servif;;o em 1996 (32 doentes) e em 1986 (32 doentes).</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Registámos: idade, sexo, grau na Escala de Coma de Glasgow (E.C.G.), reflexos fotomotores; intervalo de instalaçao coma/cirurgia, imagem na T.A.C., valores de pressão intracraniana e de pressão de perfusão cerebral e as complicações no pós operatório. Avaliámos a impotância de cada um destes factores na “Glasgow Outcome Scale” aos 6 meses após o traumatismo.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Como factor de por pognostico somentiteve comparação estatistica (teste qui-cuadrado p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05) um menor grau na resposta motora na E.C.G. no grupo de 1996.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Na decisão cirúrgica devem considerar-se os vários factores clínicos e imagiológicos. Não podemos deixar de intervir baseados apenas num factor de mau prognóstico.</p>" ] "en" => array:1 [ "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The purpose of this retrospectiv.e study was to analyze the factors influencing the outcome of patients with a severe head injury undergoing surgery in our center. Thirty-two patients were identified in 1996 and 1986.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The following information was recorded for each patient: age, sex, Glasgow Coma Scale (G.C.S.) score, interval between the first observation of coma and surgery, CT scan findings, intracranial pressure and cerebral perfusion pressure and the postoperative complications. Outcome was determined independently from assessements made at 6 months after head injury and classified according to the Glasgow Outcome Scale.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">In the group of 1996, patients with lower motor response in G.C.S. had a worse prognosis (chi-square test, p<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05).</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In the operative treatment we must consider several clinical and CT features. There is no sufficient evidence to say that any particular sign provides reliable information for withdrawal of surgical treatment.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Reis, J.L.; Pinheiro, C.; Martins, V.; Carvalho, E.: Doentes com traumatismo cranio-encefálico em coma operados. Factores de morbilidade e mortalidade. Neurocirugía 1999; 10: 345–349.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:15 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Contant, C.F., Narayan, R.K: Prognosis After Head Injury. In Youmans, eds. Neurological Surgery, 1996; 1792–1811." ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." 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