Prize in Charge of the Polytraumatized at the Center Hospitalo-Universitaire Mustapha Pacha in Algiers

Abstract

Introduction:A polytraumatized patient is a victim of violent trauma.Objective: to evaluate the management of polytrauma patients after describing their epidemiologic characteristics and to individualize the predictive factors of mortality. Materials and Methods:This is a prospective and descriptive study on the observations of 147 polytrauma patients admitted to the medical and surgical emergency department of the University Hospital Center Mustapha Pacha between June 2011 and June 2013. We have not included in the final examinations of the present, but the half-way to the vital prediction for the clinical, biologic, therapeutic and epidemiological aspects of each patient admitted for polytrauma.Results: 147 cases of polytrauma were collected: 23 women and 124 men. The average age is 38.46±2.93 years. The voices of puberty were the most common cause of trauma 69.38% The average duration of hospitality east of 14.25days±2.56 days. The average rate of care is 9.57±15.09 hours. 44.88% of our patients had 2 associated lesions. The average clinical GCS is 10.80±0.69. Respiratory distress dominates the clinical picture at admission (63.94%), consciousness disorders are observed in 80 patients (54.42%), The anisocoria was observed in 10 patients (6.80%). The thoracic lesions are predominant in our series, found in 63.26% of cases. 54.42% of polytrauma patients had head trauma associated with 18 cases (22.5%) of HED, 16 cases of HSD (20%) and cerebral edema was found in 29 cases (19.72%). The abdominal lesions were discovered in 30.61% of the cases. 57 of our patients died (38.77%). The predictive factor for mortality was: a respiratory distress syndrome (P<0.038), GCS low(P=2×10-6), the presence of anisocoria (P<0.018), inhalatory pneumonitis (P<0.01), low hemoglobin (P<10-4), and low hematocrit (P<10-4), hypoprothrombopenia (P<10-4), use of controlled ventilation (P<0.001) and vasopressor drugs (P<0.001). Blood transfusion was needed in 35.37%, controlled ventilation in 47.61% of cases and vasopressor drugs in 16.32% of cases. Ninety-two patients (62.58%) required an urgent surgical intervention. Neurosurgical procedures involved 26 patients (17.68%). The laparotomy was indispensable in 23 patients (15.64%). Conclusion:The decoration of the predictive polytraumatic based on urgent care and efficacy at the scene of the accident, for which the need for a real pre-hospital medicine, and the must be taken care of in the whole of the technical plateau needed and honed to this exercise is difficult.