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Factores que afectan la mortalidad hospitalaria en el trauma contundente hipotenso: un estudio observacional
Jong Min Woo1, Sang Won Kim2, Su Jeong Shin1
1Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Journal of Yeungnam medical science
|February 10, 2026
Resumen
Los pacientes con trauma contundente con hipotensión enfrentan altos riesgos de mortalidad. La lesión cerebral aumenta significativamente la probabilidad de muerte, haciendo hincapié en el reconocimiento y el manejo tempranos para mejores resultados en la atención del trauma.
Área de la Ciencia:
- Trauma Cirugía cirugía cirugía.
- Medicina de emergencia Medicina de emergencia.
- Salud Pública La salud pública.
Sus antecedentes:
- El trauma contundente es una de las principales causas de muerte en personas en edad de trabajar.
- La hipotensión después de un trauma contundente indica un riesgo particularmente alto de mortalidad.
- La identificación de los factores de mortalidad en pacientes con trauma contundente hipotensivo es crucial.
Objetivo del estudio:
- Para identificar los factores asociados con la mortalidad en pacientes que experimentan hipotensión después de un trauma contundente.
- Para analizar los datos a nivel nacional para las tendencias en la mortalidad por trauma contundente.
- Informar sobre el reconocimiento temprano y las estrategias de manejo para pacientes con trauma de alto riesgo.
Principales métodos:
- Se analizaron datos a nivel nacional del Sistema de Información del Departamento Nacional de Emergencias (2019-2023).
- Se incluyeron pacientes de 15 a 69 años con trauma contundente y presión arterial sistólica inicial ≤90 mmHg.
- Se seleccionaron para el análisis pacientes de alta agudeza (triaje coreano y escala de agudeza ≤3).
Principales resultados:
- De los 2.713.014 casos de trauma, 25.107 cumplían con los criterios de inclusión; el 67,0% eran hombres.
- Los accidentes de tráfico representaron el 38.8% de las lesiones.
- La lesión cerebral se asoció significativamente con la mortalidad (HR, 1.906; IC del 95%, 1.661-2.186).
- El tiempo medio desde la visita a urgencias hasta la muerte fue de 45,0 horas para los no sobrevivientes.
Conclusiones:
- La mayoría de las muertes por trauma contundente ocurren dentro de las 48 horas de la lesión.
- La lesión cerebral es un fuerte predictor de la mortalidad en pacientes con trauma contundente hipotensor.
- La gestión integral y el reconocimiento temprano son vitales para mejorar los resultados en estos casos críticos.
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