Artigos Nacionais - Resumo

Abdome agudo em paciente geriátrico.
Machado MA; Pereira EA; Lourenção JL; Branco PB.
Rev. Hosp. Clín. Fac. Med. São. Paulo , 45(1): 15-21, 1990.

 

 

Este trabalho tem a finalidade de analisar os fatores que podem estar implicados em maior índice de complicações e mortalidade nos doentes geriátricos submetidos a intervenções abdominais de emergência. Foram estudados setenta e nove doentes geriátricos (entre sessenta e noventa anos) com abdome agudo e submetidos à cirurgia abdominal de emergência no Pronto Socorro do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo no período de 1981 a 1985. Foram analisados comparativamente em três grupos etários distintos os fatores que poderiam influenciar a mortalidade pós-operatória, tais como: tempo decorrido entre a admissão e a intervenção cirúrgica, tipo de abdome agudo, duração da cirurgia, presença de doenças associadas e reoperações. A mortalidade global foi de 58,23 %. Em relação à etiologia do abdome aguda, houve uma incidência maior de abdome agudo não traumático. A maior parte dos pacientes foi submetido a tratamento cirúrgico após seis horas de admissão, retardo este que resultou em maior mortalidade destes doentes. Intervenções cirúrgicas com duração superior a três horas apresentaram uma mortalidade significativamente maior. A presença de condições mórbidas associadas elevou significativamente a mortalidade pós-operatória imediata. De todos esses dados , os autores concluíram que o de maior peso para a elevação da mortalidade é, sem dúvida, a necessidade de reoperação. Concluímos que o paciente geriátrico suporta relativamente bem uma cirurgia, porém não suas complicações, sendo aconselhável a realização de cirurgias eletivas, como correção de hérnias e remoção de cálculos da vesícula biliar, para evitar uma potencial causa de procedimentos de emergência a que estas situações podem levar, o que elevaria bastante a mortalidade

 
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