Comprehensive analysis of 4205 patients with chest trauma: a 10-year experience☆

Abstract

Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. In this retrospective study, we present our 10-year experience in the management and clinical outcome of 4205 cases with chest trauma associated with blunt and penetrating injuries in a level I trauma hospital in Turkey. In 66% of the cases, blunt injury mostly related to traffic accidents was the cause of chest trauma. Additional organ injuries were found in 35% (n=1471). Conservative treatment was administered for most patients. Tube thoracostomy was administered in 40% of all cases, whereas thoracotomy was performed in 6% (n=252), of which 209 were early interventions (P=0.001). The morbidity rate in all victims was 25.2%. The mortality rate was 9.3% for all patients and was 6.8% in blunt, 1.4% in penetrating, and 17.7% in associated organ injuries. Mortality and injury severity score (ISS) increased in patients having early surgery (P=0.001). Although most patients could be managed with conservative approaches, early thoracotomy was required in some cases. We believe that urgent hospital admission, early diagnosis, and multidisciplinary approach are very important to improve outcome.

Cardiac and great vessel injuries after chest trauma: our 10-year experience

“…Blunt injuries, especially traffic accidents, are generally much more frequent than penetrating injuries in general chest trauma. [3,4] In our series, we observed that cardiac and great vessel injuries presented with an incidence of 2% within general chest trauma. The major cause of cardiac and great vessel injuries in the current series was penetrating injuries.…”

“…Our experience in chest trauma proved that the management is based on prompt diagnosis and treatment. [4] The management strategy for cardiac and great vessel injuries at our institution is based upon the location and type of injury, and involves a multidisciplinary team approach. Cardiovascular surgeons manage cardiovascular injuries, thoracic surgeons address associated pulmonary parenchymal lacerations, and orthopedic or general surgery consultations are made when necessary.…”

Full Airway Drainage by Fiber Bronchoscopy Through Artificial Airway in the Treatment of Occult Traumatic Atelectasis

“…Atelectasis was the most common complication of thoracic trauma, with an incidence from 7.4 [8] to 14.6 % [9] in all cases. Pulmonary contusion caused by thoracic trauma can lead to airway bleeding, which may cause bronchial obstruction; cough and respiratory movement are limited by pain, which may inhibit full thoracic expansion and lead to accumulation of blood clots and sputum; severe thoracic trauma can cause pneumonia and type II alveolar epithelial cell injury, both of which may affect the production and action of pulmonary surfactant, which lead to increased alveolar surface tension and pulmonary atelectasis [10].…”

Complicaciones del Manejo Quirúrgico De Los Pacientes Con Trauma Penetrante De Tórax En Un Hospital Universitario Al Sur De Colombia

“…1 Teniendo en cuenta lo anterior, se ha reportado que el trauma de tórax es una de las mayores causas de hospitalización en el mundo y corresponde al 10-15% de los traumas, 2 con una mortalidad secundaria al trauma del 20-25% 3 a pesar de que hay estadísticas de otros países en los cuales se reportan tasas de mortalidad menores con un rango entre 4-20%. 4 De los traumas de tórax, el penetrante corresponde al 40% 5 de los pacientes, aunque hay otros estudios que reportan tasas menores correspondiendo al 34% 2 y en algunos otros, valores tan bajos como 0.8% 4 La variación entre las frecuencias de presentación del trauma penetrante son atribuidos a ambientes violentos.…”