A Novel CT Volume Index Score Correlates with Outcomes in Polytrauma Patients with Pulmonary Contusion

Strumwasser, Aaron; Chu, Edwin; Yeung, Louise; Miraflor, Emily; Sadjadi, Javid; Victorino, Gregory P.

doi:10.1016/j.jss.2011.03.022

Cited by 37 publications

(28 citation statements)

References 8 publications

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“…CTVI score was calculated based on the ratio of affected lung to total lung [slices of lung on CT × affected pixel region/lung pixel region × 0.45 (left side) + slices of lung on CT × affected pixel region/lung pixel region × 0.55(right side)].) [ 8 ]; 3. Adults over 18 years old; 4.…”

Section: Methodsmentioning

confidence: 99%

Ten-year retrospective analysis of multiple trauma complicated by pulmonary contusion

et al. 2014

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BackgroundThis study reports a 10-year retrospective analysis of multiple trauma complicated by pulmonary contusion. The purpose of this study is to ascertain the risk factors for mortality due to trauma in patients with pulmonary contusion, the impact of various treatment options for prognosis, and the risk factors for concurrent Acute Respiratory Distress Syndrome (ARDS).MethodsWe retrospectively analyzed 252 trauma patients with lung contusion admitted to the General Hospital of Guangzhou Command from January 2000 to June 2011 by using the statistical processing system SPSS 17.0 for Windows.ResultsWe included 252 patients in our study, including 214 males and 38 females. The average age was 37.1 ± 14.9 years. There were 110 cases admitted to the ICU, of which 26 cases with ARDS. Nine of the 252 patients died. We compared those who survived with those who died by gender and age, the difference was not statistically significant (P = 0.199, P = 0.200). Separate univariate analysis of those who died and those who survived found that shock on admission (P = 0.000), coagulation disorders (P = 0.000), gastrointestinal bleeding (P = 0.02), the need for emergency surgery on admission (P = 0.000), pre-hospital intubation (P = 0.000), blood transfusion within 24 hours (P = 0.006), the use of mechanical ventilation (P = 0.000), and concurrent ARDS (P = 0.000) are poor prognosis risk factors. Further logistic analysis, including the admission GCS score (OR = 0.708, 95% CI 0.516-0.971, P = 0.032), ISS score (OR 1.135, 95% CI 1.006-1.280, P = 0.039), and concurrent ARDS (OR = 15.814, 95% CI 1.819-137.480, P = 0.012), identified the GCS score, ISS score and concurrent ARDS as independent risk factors of poor prognosis. Shock (OR = 9.121, 95% CI 0.857-97.060, P = 0.067) was also related to poor prognosis. Patients with injury factors such as road accident, falling injury, blunt injury and crush injury, et al.(P = 0.039), infection (P = 0.005), shock (P = 0.004), coagulation disorders (P = 0.006), emergency surgery (P = 0.01), pre-hospital intubation (P = 0.000), chest tube insertion (P = 0.004), blood transfusion (P = 0.000), usage of hormones (P = 0.002), phlegm (P = 0.000), ventilation (P = 0.000) were at a significantly increased risk for ARDS complications.ConclusionsThose patients with multiple trauma and pulmonary contusion admitted to the hospital with shock, coagulopathy, a need for emergency surgery, pre-hospital intubation, and a need for mechanical ventilation could have a significantly increased risk of mortality and ARDS incidence. A risk for poor prognosis was associated with gastrointestinal bleeding. A high ISS score, high APACHE2, and low GCS score were independent risk factors for poor prognosis. If patients developed an infection or were given drainage, hormones, and phlegm treatment, they were at higher risk of ARDS. Pre-hospital intubation and drainage were independent risk factors for ARDS. In patients with ARDS, the ICU stay, total length of stay, and hospital costs might increase significantly. A GCS sc...

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Section: Methodsmentioning

confidence: 99%

Ten-year retrospective analysis of multiple trauma complicated by pulmonary contusion

et al. 2014

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“…These authors showed that as the pulmonary contusion percentage exceeded 20% of total lung parenchyma, a sharp increase in the incidence of ARDS occurred [35-37]. Some suggest that this could potentially be utilized as a screening tool and enable appropriate lung protective strategies early in the patient’s course.…”

Section: Introductionmentioning

confidence: 99%

Acute lung injury and the acute respiratory distress syndrome in the injured patient

Bakowitz

Bruns

McCunn

2012

Scand J Trauma Resusc Emerg Med

114

102

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Acute lung injury and acute respiratory distress syndrome are clinical entities of multi-factorial origin frequently seen in traumatically injured patients requiring intensive care. We performed an unsystematic search using PubMed and the Cochrane Database of Systematic Reviews up to January 2012. The purpose of this article is to review recent evidence for the pathophysiology and the management of acute lung injury/acute respiratory distress syndrome in the critically injured patient. Lung protective ventilation remains the most beneficial therapy. Future trials should compare intervention groups to controls receiving lung protective ventilation, and focus on relevant outcome measures such as duration of mechanical ventilation, length of intensive care unit stay, and mortality.

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“…Wang and colleagues [28] reported that the volume of pulmonary contusions in blunt chest trauma was an independent predictor factor for ARDS. Similarly, Strumwasser and colleagues [29] found that a pulmonary contusion volume greater than 20% of the total lung volume predicted, with good sensitivity and specificity, the development of ARDS. However, quantitative analysis of the whole lung is labor intensive and time consuming, as it requires the manual delineation of each lung section.…”

Section: Reviewmentioning

confidence: 92%

Clinical review: Lung imaging in acute respiratory distress syndrome patients - an update

et al. 2013

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Over the past 30 years lung imaging has greatly contributed to the current understanding of the pathophysiology and the management of acute respiratory distress syndrome (ARDS). In the past few years, in addition to chest X-ray and lung computed tomography, newer functional lung imaging techniques, such as lung ultrasound, positron emission tomography, electrical impedance tomography and magnetic resonance, have been gaining a role as diagnostic tools to optimize lung assessment and ventilator management in ARDS patients. Here we provide an updated clinical review of lung imaging in ARDS over the past few years to offer an overview of the literature on the available imaging techniques from a clinical perspective.

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A Novel CT Volume Index Score Correlates with Outcomes in Polytrauma Patients with Pulmonary Contusion

Cited by 37 publications

References 8 publications

Ten-year retrospective analysis of multiple trauma complicated by pulmonary contusion

Ten-year retrospective analysis of multiple trauma complicated by pulmonary contusion

Acute lung injury and the acute respiratory distress syndrome in the injured patient

Clinical review: Lung imaging in acute respiratory distress syndrome patients - an update

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