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      Características epidemiológicas del trauma abdominal en el Hospital Viedma, Cochabamba, Bolivia Translated title: Epidemiological characteristics of abdominal trauma at the hospital viedma, Cochabamba, Bolivia

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          Abstract

          Objetivos: analizar las características epidemiológicas del trauma abdominal en pacientes de 18 a 78 años atendidos en el Complejo Hospitalario Viedma de la ciudad de Cochabamba, durante el periodo de enero del 2011 a julio del 2012. Métodos: se realiza un estudio de tipo observacional y de corte transversal en 31 registros de pacientes con diagnóstico confirmado de trauma abdominal, considerando una seguridad del 95%, a=0,05 y Z1-a =0,76; seleccionados por muestreo aleatorio no probabilístico sistémico. Resultados: el grupo más vulnerable son los varones (71%), el mecanismo más frecuente son los accidentes automovilísticos (32%); el diagnóstico de ingreso y egreso más frecuente fué trauma abdominal cerrado (65%). La técnica quirúrgica más empleada fue laparotomía exploratoria y rafia de viscera hueca (87%y52%), la complicación más frecuente el hemoperitoneo (16%). Conclusiones: existe una relación directa y estadísticamente significativa entre el tiempo demorado para el ingreso a quirófano y la estadía intrahospitalaria en pacientes ingresados por trauma abdominal independientemente de su tipología (COVAR=22,24 y R²=0,5335).

          Translated abstract

          Objectives: to analyze the epidemiological characteristics of abdominal trauma in patients 18 to 78 years treated at the Hospital Viedma city of Cochabamba, during the period January 2011 to July 2012. Methods: we performedis a study of observational and cross-sectional records in 31 patients with confirmed diagnosis of abdominal trauma, considering a 95% confidence, a = 0.05 and Z1-a = 0.76, selected by non-probability random sampling systemic. Results: the most vulnerable group are men (71%), the most common mechanism are motor vehicle accidents (32%), the diagnosis of most frequent entry and exit was closed abdominal trauma (65%). The surgical technique used was exploratory laparotomy and raffia hollow viscera (87% Y52%), the most common complication hemoperitoneum (16%). Con-clusions: there is a statistically significant relationship between the time elapsed for admission to the operating room and hospital stay in patients admitted for abdominal trauma regardless of their type (COVAR = 22.24 and R2 = 0.5335).

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          Practice management guidelines for the evaluation of blunt abdominal trauma: the East practice management guidelines work group.

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            The value of laparoscopy in management of abdominal trauma.

            The role of laparoscopy (LS) in abdominal trauma is controversial. Concerns remain regarding missed injuries and safety. Our objective for this study was to determine the safety and better define the role of LS in abdominal trauma victims. We performed a retrospective review of all patients who sustained abdominal trauma and underwent LS in a level I trauma center. The main outcome measures were age, gender, mechanism of injury (MOI), indication for laparoscopy, presence of intra-abdominal injury (IA), therapeutic laparoscopy (TxLS), need for laparotomy, length of hospital stay (LOS), missed injuries, complications, and deaths. Forty-eight patients underwent LS (62 per cent male; average age, 28 years; MOI, 35 (85%) penetrating, 7 (15%) blunt; mean ISS, 8). At laparoscopy, 58 per cent of patients had no intra-abdominal injury. IA injury was treated with laparotomy in 14 (29%) and TxLS in 6 (13%). One patient had a negative laparotomy (2%). No injuries were missed. No patients required reoperation. There was one complication: a pneumothorax. There were no deaths. LS was most valuable in penetrating trauma, avoiding laparotomy in more than two-thirds of patients with suspected intra-abdominal injury. LS can serve as a useful adjunct for the evaluation of blunt trauma. In a level I trauma center with LS readily available, the procedure is associated with a low rate of complications and missed injury.
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              Unsuspected internal organ traumatic injuries.

              Emergency medicine physicians can avoid missed traumatic intra-abdominal injury by adopting a paradigm for patient evaluation that recognizes the patterns of injury associated with pathology, the importance of positive and negative physical findings, and the limitations of diagnostic studies. The burden of avoiding missed traumatic injuries does not rest with emergency medicine physicians alone, however. A missed diagnosis may be the result of a medical error involving multiple systems and individuals.Ultimately, decreasing the incidence of missed traumatic injury is an opportunity for quality improvement for all practitioners involved in the care of patients with trauma.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                gmb
                Gaceta Médica Boliviana
                Gac Med Bol
                Facultad de Medicina de la Universidad Mayor de San Simón (Cochabamba, , Bolivia )
                1012-2966
                December 2012
                : 35
                : 2
                : 67-71
                Affiliations
                [02] Cochabamba orgnameUniversidad Mayor de San Simón orgdiv1facultad de Medicina Bolivia
                [01] Cochabamba orgnameVisión Mundial Bolivia Programa de Desarrollo de Área Bolivia
                Article
                S1012-29662012000200005
                77660335-36e4-4360-9fd6-ecaba6798627

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 26 November 2012
                : 29 October 2012
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 12, Pages: 5
                Product

                SciELO Bolivia


                trauma abdominal,correlación,epidemiología,abdominal trauma,correlation,epidemiology

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