Development of posttraumatic empyema in patients with retained hemothorax

DuBose, Joseph J.; Inaba, Kenji; Okoye, Obi; Δημητριάδης, Δημήτριος; Scalea, Thomas M.; O’Connor, James V.; Menaker, Jay; Morales, Carlos; Shiflett, Tony; Brown, Carlos; Copwood, Ben

doi:10.1097/ta.0b013e31825c1616

Cited by 102 publications

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“…There was a higher incidence of empyema when the injury was on the left side of the thorax, but without statistical significance. Evidence indicates that the rib fractures on the left side would be more associated with empyema 8,12,17 , corroborating with the findings of this study.…”

Section: Discussion Discussion Discussion Discussion Discussionsupporting

confidence: 82%

“…The primary indication for drainage was hemopneumothorax in 39 patients (65.0%) corroborating previous findings 12 . Patients with hemothorax had a higher incidence of empyema (38.9%) than those with isolated pneumothorax (33.3%) or hemopneumothorax (30.8%), which is quite reasonable since, in the former case, the risk to develop empyema is increased when blood accumulates in the pleural cavity, working as a culture medium for bacteria.…”

Section: Discussion Discussion Discussion Discussion Discussionsupporting

confidence: 79%

“…Patients with penetrating trauma by firearms had significantly lower risk of empyema compared to those with penetrating trauma with knives and blunt trauma. The literature tends to high quote the penetrating mechanism as a risk factor for empyema, but this is controversial and the reasons are not objectively clarified 3,4,12,16 . Another study in Brazil has found similar results to this work regarding the incidence of empyema according to the mechanism of trauma 19 .…”

Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 99%

“…However, this definition is still not uniform in the medical literature 6 . Less invasive procedures have been early indicated for treatment of RH [7][8][9][10][11][12] . The main goal of the early treatment is to avoid the RH progression to other complications, especially to empyema, one of the most severe complication which frequently requires a complex approach for treatment 5,12,13 .…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

“…Less invasive procedures have been early indicated for treatment of RH [7][8][9][10][11][12] . The main goal of the early treatment is to avoid the RH progression to other complications, especially to empyema, one of the most severe complication which frequently requires a complex approach for treatment 5,12,13 . The RH is the main predisposing factor for post-traumatic empyema and the incidence varies from 4% to 20% 5,7,13,14 .…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

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Associated factors to empyema in post-traumatic hemotorax

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et al. 2015

Rev. Col. Bras. Cir.

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Objective:to analyze the associated factors with empyema in patients with post-traumatic retained hemothorax.Methods:prospective observational study. Data were collected in patients undergoing PD during emergency duty. Variables analyzed were age, sex, mechanism of injury, side of the chest injury, intrathoracic complications of RH, laparotomy, specific injuries, rib fractures, trauma scores, days to diagnosis, diagnostic method of RH, primary indication of PD, initial volume drained, length of the first tube removal, surgical procedure. Cumulative incidence of empyema, pneumonia and pulmonary contusion and the proportion of patients with empyema or without empyema in each category of each variable analyzed were obtained.Results: the cumulative incidence of PD among trauma patients was 1.83% and the RH among those with PD was 10.63%. There were 20 cases of empyema (32.8%). Most were male in the age from 20 to 29, victims of injury by firearm on the left side of the thorax. The incidence of empyema in patients with injury by firearms was lower compared to those with stab wound or blunt trauma; higher among those with drained volume between 300 and 599 ml. The median hospital lenght of stay was higher among those with empyema.Conclusion:the incidence of PD was 1.83% and RH was 10.63%, these results are consistent with the low severity of the patients involved in this study and consistent with the literature. The incidence of empyema proved to be negatively associated with the occurrence of injury by firearms and positively associated with a drained volume between 300 and 599 ml, compared with lower or higher volumes.

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Section: Discussion Discussion Discussion Discussion Discussionsupporting

confidence: 82%

Section: Discussion Discussion Discussion Discussion Discussionsupporting

confidence: 79%