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- Open Access
Prognostic factors of poor outcome in patients with upper limb replantation surgery admitted to the icu
© Portugal Rodríguez et al.; 2015
- Published: 1 October 2015
- Electronic Medical Record
- Injury Mechanism
- Postoperative Care
- Arterial Thrombosis
- Care Variable
Our University Hospital is one of the national reference centers in upper extremity replantation surgery (ERS) (the transfer is carried out on air transportation by the National Transplant Organization, NTO). Therefore, it is important to optimize postoperative care in the ICU that may influence replantation evolution.
To describe the characteristics of patients undergoing this surgery admitted to the ICU and to evaluate prognostic factors related with bad outcome .
Observational study of patients with ERS during a period of seven years (2008-2014). Computer research of electronic medical records in databases was conducted. We obtained a sample of 60 cases and classified them into two groups: good and poor outcome. We analyzed: epidemiological variables (age, smoking, diabetes, arteriopathy) variables related with injury mechanism (degloving, flattening, large bone lesion, neural lost and vascular affectation), surgery and postoperative care (amines, mechanical ventilation, transfusion, ICU stay).
We compared the factors associated with poor outcome in both groups
Good outcome (n = 30)
Bad outcome (amputation, n = 30)
Injury mechanism(%) (degloving, flattening)
Large bone lesion(%)
Large vascular affectation (%)
Large neural lost(%)
Warm ischemia time (mean hours ± SD)
4,0 ± 1,44
4.36 ± 1.45
Surgery time (median hours, IQR)
In our sample, large bone and vascular affectation were the factors associated with poor replantation outcome, in patients with upper extremity amputation. No differences related with surgical or postoperative care variables were observed. Replantation survival rates, and need of reoperation in our series, were consistent with literature data .
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