<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1608-8921</journal-id>
<journal-title><![CDATA[Gaceta Médica Espirituana]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Méd Espirit]]></abbrev-journal-title>
<issn>1608-8921</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Ciencias Médicas de Sancti Spíritus]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1608-89212022000200008</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Predictores de mortalidad precoz en pacientes con trauma complejo hemorrágico]]></article-title>
<article-title xml:lang="en"><![CDATA[Early mortality predictors in patients with complex hemorrhagic trauma]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valdés Rodríguez]]></surname>
<given-names><![CDATA[Manuel Felipe]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez Corvea]]></surname>
<given-names><![CDATA[Laureano]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Condes Fernández]]></surname>
<given-names><![CDATA[Berto Delis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Orellana Meneses]]></surname>
<given-names><![CDATA[Geovanis Alcides]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Provincial General Camilo Cienfuegos  ]]></institution>
<addr-line><![CDATA[Sancti Spíritus ]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Ciencias Médicas  ]]></institution>
<addr-line><![CDATA[Sancti Spíritus ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2022</year>
</pub-date>
<volume>24</volume>
<numero>2</numero>
<fpage>0</fpage>
<lpage>0</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1608-89212022000200008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1608-89212022000200008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1608-89212022000200008&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Fundamento:  El trauma complejo es un problema de salud a nivel mundial y cuando es de tipo hemorrágico la mortalidad es superior a los otros tipos de traumas complejos.  Objetivo:  Determinar las variables predictoras de mortalidad precoz en pacientes hospitalizados con trauma complejo hemorrágico en una institución hospitalaria del segundo nivel de atención en Cuba.  Metodología:  Se realizó un estudio transversal en el Hospital General Provincial Camilo Cienfuegos de Sancti Spíritus, durante 6 años. Se incluyeron 207 pacientes. Las variables se agruparon en sociodemográficas, enfermedades crónicas asociadas, mecanismo lesional, tipo de trauma, localización topográfica, tiempo entre admisión hospitalaria, diagnóstico y tratamiento, complicaciones precoces, tratamiento médico y quirúrgico, y mortalidad precoz. Se elaboró un árbol de decisión mediante el método Chaid exhaustivo, la variable dependiente fue la mortalidad por trauma complejo hemorrágico.  Resultados: Predominaron los pacientes del sexo masculino (85 %), con 60 años y menos (83 %), con trauma contuso (57.5 %) y politraumatizados (42.5 %). Predominaron también los que presentaron acidosis metabólica (66.7 %), coagulopatía aguda (44.4 %), hipotermia (41.5 %). El 30 % de los pacientes falleció precozmente. El árbol de decisión tuvo una sensibilidad de 82.3 %, una especificidad de 97.2 % y un porcentaje global de pronóstico correcto del 92.8 %. Se identificaron 4 variables predictores de mortalidad: hipotermia, acidosis metabólica, coagulopatía aguda y trauma penetrante.  Conclusiones: La probabilidad más alta de fallecer precozmente durante un trauma complejo hemorrágico se da entre pacientes con hipotermia, acidosis metabólica, coagulopatía aguda y trauma penetrante.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Background:  Complex trauma is a worldwide health problem and when hemorrhagic, mortality is higher than other types of complex trauma.  Objective:  To determine predictive variables of early mortality in hospitalized patients with complex hemorrhagic trauma in a second care level hospital in Cuba.  Methodology:  A cross-sectional study was conducted at Camilo Cienfuegos Provincial General Hospital in Sancti Spíritus, for 6 years. 207 patients were included. The variables were grouped into sociodemographic, associated chronic diseases, injury mechanism, type of trauma, topographic location, time between hospital admission, diagnosis and treatment, early complications, medical and surgical treatment, and early mortality. A decision tree was developed using the exhaustive Chaid method, the dependent variable was mortality due to complex hemorrhagic trauma.  Results:  Male patients (85 %), 60 years and younger (83 %), with blunt trauma (57.5 %) and polytraumatized patients (42.5 %) predominated. Those who presented metabolic acidosis (66.7 %), acute coagulopathy (44.4 %), and hypothermia (41.5 %) also predominated. 30 % of patients died early. The decision tree had a sensitivity of 82.3 %, a specificity of 97.2 % and an overall percentage of correct forecast of 92.8 %. Four variables that predicted mortality were identified: hypothermia, metabolic acidosis, acute coagulopathy, and penetrating trauma.  Conclusions:  The highest probability of early dying during a complex hemorrhagic trauma occurs among patients with hypothermia, metabolic acidosis, acute coagulopathy and penetrating trauma.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Variables predictoras]]></kwd>
<kwd lng="es"><![CDATA[trauma complejo]]></kwd>
<kwd lng="es"><![CDATA[trauma complejo hemorrágico]]></kwd>
<kwd lng="es"><![CDATA[mortalidad precoz]]></kwd>
<kwd lng="es"><![CDATA[CHOQUE HEMORRÁGICO y cirugía]]></kwd>
<kwd lng="es"><![CDATA[CHOQUE TRAUMÁTICO y cirugía]]></kwd>
<kwd lng="es"><![CDATA[ACIDOSIS y mortalidad]]></kwd>
<kwd lng="es"><![CDATA[HIPOTERMIA y mortalidad]]></kwd>
<kwd lng="en"><![CDATA[Predictive variables]]></kwd>
<kwd lng="en"><![CDATA[complex trauma]]></kwd>
<kwd lng="en"><![CDATA[complex hemorrhagic trauma]]></kwd>
<kwd lng="en"><![CDATA[early mortality]]></kwd>
<kwd lng="en"><![CDATA[shock hemorrhagic and surgery]]></kwd>
<kwd lng="en"><![CDATA[shock traumatic and surgery]]></kwd>
<kwd lng="en"><![CDATA[acidosis and mortality]]></kwd>
<kwd lng="en"><![CDATA[hypothermia and mortality]]></kwd>
</kwd-group>
</article-meta>
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