2020, Number 06
Factors associated with mortality in damage control surgery in severe obstetric hemorrhage
Jiménez-Jiménez G, Villalobos-Lizardi JC, López-Aceves LJ
Full text
Language: Spanish
References: 9
Page: 380-384
PDF size: 227.78 Kb.
ABSTRACT
Objective: To identify the risk factors related to mortality in damage control surgery in patients with severe obstetric hemorrhage.Materials and Methods: Descriptive, retrospective, observational study at the Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Mexico. The records for the period between January 2016 and December 2019 were reviewed. Patients with damage control surgery for severe obstetric hemorrhage were included. Non-hysterectomized patients were excluded. The clinical and surgical characteristics and Its fatal outcome was considered descriptive and inferential parametric statistics.
Results: 45 patients were included. The mean age was 30 years (SD ± 6.7). The most frequent reason for bleeding was uterine atony (15/45). The mean of bleeding was 3983 (SD ± 1695) mL, the mean of compresses was 5.3 compresses (SD ± 1.6). Half of the complicated sample (22/45). Patients who had uterine rupture and thromboembolism were 9.7 times more likely to die than the rest (p = 0.043). In addition, an association was found between patients who had sepsis and died (p = 0.002). Bleeding (p = 0.034), days of hospital stay (p = 0.022), and number of surgeries (p = 0.028) were associated with mortality.
Conclusions: The number of surgeries, bleeding, the days of hospital stay, uterine rupture, as well as the patients who suffer the following complications; sepsis, pulmonary thromboembolism, were associated with a significant increase in mortality.
REFERENCES
Diagnóstico y tratamiento de la hemorragia obstétrica en la segunda mitad del embarazo y puerperio inmediato. Evidencias y recomendaciones. Catálogo Maestro de Guías de Práctica Clínica: IMSS-162-09. 2009. http://www.cenetec. salud.gob.mx/descargas/gpc/CatalogoMaestro/162_GPC_ HEMORRAGIA_OBSTETRICA/Imss_162ER.pdf