Caracterización clínica y epidemiológica del síndrome de dificultad respiratoria aguda en pacientes adultos con fractura diafisaria de fémur

Abstract

ObjectiveTo describe the epidemiology of post-traumatic acute respiratory distress syndrome. MethodologyDescriptive observational study of patients with traumatic femoral shaft fracture requiring surgical management. The variables included in the analysis were demographics, injury severity, treatment methods, and in-hospital outcomes. A descriptive multivariate analysis was performed in order to explore the factors associated with the development of Acute Respiratory Distress Syndrome (ARDS). ResultsOf the 267 patients with femoral fractures, 86% were male patients with a mean age of 28.7 years and Injury Severity Score (ISS) of 12.7. The overall prevalence of ARDS was 8.6% while the prevalence among multiple trauma patients was 20%. Mortality was 7.5%. In the bivariate analysis, the variables associated with ARDS were the following: time between the trauma and hospital admission, ISS, contused lung, associated tibial fracture, urgent surgery requirement, and need for red blood cell transfusion. In the multivariate analysis, the associated variables were: blunt chest trauma, time elapsed until definitive fixation, and red blood celltrans fusion during surgery.In the cohort, there was an increase in the annual prevalence of ARDS, from 4.3% in 2006 to 26.1% in 2011, as was also the case with multiple trauma, which increased from 14.5% in 2006 to 23.6% in 2011. A change in treatment was also evidenced, with increase in early total care (ETC) and damage control orthopaedics (DCO). ConclusionsIn our population, the prevalence of ARDS in patients with femoral fractures increases when associated with blunt chest trauma, delayed stabilization time, and the need for blood transfusion.