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Delayed fixation of fractures
9%
125/1441
Decreased intracranial pressure
5%
66/1441
Intra-abdominal injury
124/1441
Intra-operative hypotension
74%
1065/1441
Decreased platelet count
4%
52/1441
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The factor most likely to adversely affect long term outcome in poly-trauma patients with severe brain injury is intraoperative hypotension. Chesnut et al demonstrated that hypotension (SBP <90mmHg) was profoundly detrimental, occurring in 35% of these patients and associated with 150% increase in mortality. Pietropaoli et al reviewed 53 patients with severe head injuries and required early surgical intervention (surgery within 72 hours of injury). All patients were initially normotensive on arrival. There were 17 patients (32%) who developed intra-operative hypotension and 36 (68%) who remained normotensive throughout surgery. The mortality rate was 82% in the IH group and 25% in the normotensive group.
3.2
(34)
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