Preditores de mortalidade em pacientes neurocirúrgicos após trauma cranioencefálico

Autores

  • Bruno Bastos Godoi
  • Silvio Pereira Ramos Junior
  • Pedro Henrique Scheidt Figueiredo
  • Henrique Silveira Costa
  • Samara Barroso de Figueiredo
  • Lucas Mendes Melo
  • Márcio Guilherme Leite Verssiane
  • Pedro Lorentz Ribeiro Innecco

DOI:

https://doi.org/10.22290/jbnc.v32i4.1987

Palavras-chave:

Lesões cerebrais traumáticas, Neurocirurgia, Escala de Coma de Glasgow, Análise de sobrevivência

Resumo

Introdução: O traumatismo cranioencefálico (TCE) é considerado importante causa mundial de mortalidade e morbidade. Objetivo: Avaliar de forma independente os fatores na admissão hospitalar e durante a internação que predizem mortalidade intra-hospitalar em pacientes com TCE submetidos a neurocirurgia. Métodos: Coorte retrospectiva com análise de dados de pacientes submetidos à neurocirurgia devido ao TCE. Os fatores preditores avaliados foram idade, sexo, Escala de Coma de Glasgow (ECG) na admissão, sequelas antes e depois da neurocirurgia, mecanismo de trauma e procedimento neurocirúrgico. As análises de sobrevivência foram verificadas. Valores preditivos positivos e negativos foram calculados. Resultados: Foram analisados 312 pacientes, a maioria do sexo masculino (81,4%) com TCE leve (55,8%), e com média de idade de 49,6 ± 23,5 anos. A ECG na admissão foi um preditor independente de mortalidade (HR = 0,87; IC 95%: 0,81 a 0,93; p <0,001). O GCS ≤ 13 foi o valor de corte ideal para prever a sobrevivência com uma diferença significativa entre os grupos ECG (≤13 ou> 13; p <0,001). Pacientes com ECG ≤ 13 tiveram risco seis vezes maior de mortalidade (HR 6,04; IC95 2,39 a 15,3; p <0,001). Os valores preditivos positivo e negativo foram 35,8% e 97%, respectivamente. Conclusões: A ECG na admissão é importante preditor de mortalidade hospitalar em pacientes com TCE que necessitam de procedimento neurocirúrgico.

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Biografia do Autor

Bruno Bastos Godoi

MD, Faculty of Medicine, Federal University of Jequitinhonha’s Valley and Mucuri, Diamantina, Brazil

Silvio Pereira Ramos Junior

MD, PhD. Faculty of Medicine, Federal University of Jequitinhonha’s Valley and Mucuri, Diamantina, Brazil

Pedro Henrique Scheidt Figueiredo

PhD. Postgraduate Program in Rehabilitation and Functional Performance, Physical Therapy School, Federal University of Jequitinhonha’s Valley and Mucuri, Diamantina, Brazil

Henrique Silveira Costa

PhD. Postgraduate Program in Rehabilitation and Functional Performance, Physical Therapy School, Federal University of Jequitinhonha’s Valley and Mucuri, Diamantina, Brazil

Samara Barroso de Figueiredo

Faculty of Medicine, Federal University of Jequitinhonha’s Valley and Mucuri, Diamantina, Brazil

Lucas Mendes Melo

Faculty of Medicine, Federal University of Jequitinhonha’s Valley and Mucuri, Diamantina, Brazil

Márcio Guilherme Leite Verssiane

Faculty of Medicine, Federal University of Jequitinhonha’s Valley and Mucuri, Diamantina, Brazil

Pedro Lorentz Ribeiro Innecco

Faculty of Medicine, Federal University of Jequitinhonha’s Valley and Mucuri, Diamantina, Brazil

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Publicado

2022-01-06

Como Citar

1.
Godoi BB, Ramos Junior SP, Figueiredo PHS, Costa HS, Figueiredo SB de, Melo LM, Verssiane MGL, Innecco PLR. Preditores de mortalidade em pacientes neurocirúrgicos após trauma cranioencefálico. jbnc [Internet]. 6º de janeiro de 2022 [citado 26º de maio de 2022];32(4):357-66. Disponível em: https://jbnc.emnuvens.com.br/jbnc/article/view/1987

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