Even more critical medicine: a retrospective analysis of casualties admitted to the intensive care unit in the Spanish Military Hospital in Herat (Afghanistan)
Medicina aún más crítica: análisis retrospectivo de las bajas atendidas en la UCI del Hospital Militar español de Herat (Afganistán)
R. Navarro Suaya,
, E. Bartolomé Celab, I. Jara Zozayac, A. Hernández Abadía de Barbaráb, C. Gutiérrez Ortegad, J.D. García Labajoe, A. Planas Rocaf, F. Gilsanz Rodríguezg
Corresponding author
a Escuela Militar de Sanidad, Madrid, Spain
b Medicina Intensiva, Hospital Central de la Defensa, Madrid, Spain
c Medicina Intensiva, Hospital General de la Defensa, Zaragoza, Spain
d Servicio de Calidad y Medicina Preventiva, Hospital Central de la Defensa, Madrid, Spain
e Medicina Intensiva, Escuela Militar de Sanidad, Madrid, Spain
f Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario La Princesa, Madrid, Spain
g Anestesiología, Reanimación y Terapéutica del Dolor, President of the Sociedad Española de Anestesiología, Reanimación y Terapéutica
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Applying the NISS, 38% of the casualties had suffered severe injuries. Mean stay in the ICU was 2.8 days and mortality was 10%. Significant differences in admission to the ICU for the damaging agent were not observed (P = .142).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">No significant differences were observed in the need for admission and stay in the ICU according to the damaging agent. The importance of the strategy, care and logistics of the intensive care military physician in Intensive Medicine in the Operating Room in Afghanistan is stressed.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Analizar las bajas por arma de fuego o por explosivo que ingresaron en la UCI del ROLE-2E español entre diciembre de 2005 y diciembre de 2008 y valorar mediante puntuaciones anatómicas de gravedad (ISS y NISS) cuál es el agente lesional que ha producido mayor morbimortalidad en nuestra serie.</p> <span class="elsevierStyleSectionTitle">Diseño</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional retrospectivo efectuado entre los años 2005 y 2008.</p> <span class="elsevierStyleSectionTitle">Ámbito</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Unidad de Cuidados Intensivos polivalente del Hospital Militar español desplegado en Afganistán.</p> <span class="elsevierStyleSectionTitle">Pacientes o participantes</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">El criterio de inclusión fue el de todos los pacientes que sufrieron heridas por arma de fuego o lesiones por artefacto explosivo y que fueron ingresados en la UCI del Hospital Militar español de Herat (Afganistán).</p> <span class="elsevierStyleSectionTitle">Intervenciones</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">A los pacientes seleccionados se les aplicó las puntuaciones anatómicas Injury Severity Score (ISS) y New Injury Severity Score (NISS) para estimar el grado de gravedad de sus lesiones.</p> <span class="elsevierStyleSectionTitle">Variables de interés</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Independientes: agente lesional, área anatómica afectada, empleo de medios de protección, y dependientes: mortalidad, necesidad de intervención quirúrgica, gravedad según scores, y sociodemográficas y de control.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Ochenta y seis bajas; 30 por arma de fuego y 56 por artefacto explosivo. El 38% estaba valorado como grave por NISS. La estancia media fue de 2,8 días y la mortalidad del 10%. No se observan diferencias significativas de ingresos en UCI según el agente lesional (p = 0,142).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">No se observan diferencias significativas en necesidad de ingreso y de la estancia en UCI según el agente causante de las lesiones. Se destaca la importancia táctica, asistencial y logística del médico militar especialista en medicina intensiva en el teatro de operaciones de Afganistán.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:40 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Afganistán. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 10 | 14 | 24 |
| 2024 October | 37 | 63 | 100 |
| 2024 September | 33 | 37 | 70 |
| 2024 August | 40 | 63 | 103 |
| 2024 July | 25 | 51 | 76 |
| 2024 June | 21 | 39 | 60 |
| 2024 May | 22 | 33 | 55 |
| 2024 April | 20 | 48 | 68 |
| 2024 March | 26 | 41 | 67 |
| 2024 February | 21 | 50 | 71 |
| 2024 January | 24 | 49 | 73 |
| 2023 December | 16 | 51 | 67 |
| 2023 November | 17 | 31 | 48 |
| 2023 October | 19 | 47 | 66 |
| 2023 September | 14 | 44 | 58 |
| 2023 August | 16 | 26 | 42 |
| 2023 July | 14 | 34 | 48 |
| 2023 June | 16 | 16 | 32 |
| 2023 May | 12 | 19 | 31 |
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