Predictors of mortality in trauma surgery

Damage control surgery is used in patients with severe trauma and hemodynamic instability, but mortality remains high, particularly in low- and middle-income countries. AIM: To identify the clinical and laboratory factors associated with mortality in patients who underwent damage control surgery at San Juan de Dios Hospital between 2018 and 2022. METHODS: A retrospective observational descriptive study was conducted, including 66 medical records. Clinical, hemodynamic, and coagulation variables, as well as the use of tranexamic acid and mortality, were collected using a structured questionnaire. Data were analyzed using EpiInfo and STATA 17. Descriptive statistics, Student’s t-test, and chi-square/Fisher’s exact tests were applied, with statistical significance set at p < 0.05. RESULTS: A total of 66 patients were analyzed, predominantly young men (78.8%, mean age 32 years). The overall mortality rate was 68.2%. Factors significantly associated with higher mortality were: lower Glasgow Coma Scale score at admission (10.2 vs. 12.8, p=0.04), lower pH (7.13 vs. 7.20, p=0.04), and a higher number of red blood cell transfusions (4.92 vs. 3.52 units, p=0.01). The use of tranexamic acid showed no significant association with mortality (p=0.057). CONCLUSION: Mortality in damage control surgery was 68.2%. The identified predictors of mortality were a low Glasgow Coma Scale score on admission, severe metabolic acidosis (low pH), and the need for multiple transfusions. Tranexamic acid did not demonstrate a significant benefit in terms of survival in this population.