Evaluation of Lung Contusion, Associated Injuries, and Outcome in a Major Trauma Center in Shiraz, Southern Iran

Abstract

Objective. Blunt chest trauma as one of the most common injuries in trauma cases can cause significant morbidity and mortality. The purpose of this study was to determine the clinical course of traumatic injuries with an initial diagnosis of a pulmonary contusion in patients. Method. In this retrospective study, we evaluated the demographic and clinical features of patients who were referred to a major trauma center in southern Iran. In our study, patients were enrolled with the diagnosis of pulmonary contusion. All included patients were above 16 years of age, with an initial CT scan in favor of pulmonary contusion, while patients not being hospitalized for more than 48 hours were excluded from the study. Results. Among the 434 patients included in our study, 366 (84%) were male and the mean age was 41.17 (SD = 17.89). Among them, the majority (80.4%) had right side lung contusion and 47 patients (10.8%) had right rib fracture. The most common injuries were head and neck injury (56.9%) and limbs (30%). In 25% of cases, pulmonary contusion was associated with pneumothorax and 15.8% with hemothorax. Also, 49.6% of patients were transferred to the ICU. The mortality rate in our study was 15.2% (n = 66). Conclusion. Although recent advances in pulmonary care and ventilator management have been achieved, there is still considerable morbidity and mortality associated with this condition. Therefore, there is a need to provide a national guideline based on native patient information for better management.

Evaluation of the appropriate use of chest CT-Scans in the diagnosis of hospitalized patients in shiraz teaching hospitals, Southern Iran

“…Also, based on ACR criteria, collectively, 62% of requested CT scan was "usually appropriate" and "maybe appropriate". The various trend of CT imaging utilization was recently evaluated [9][10][11][12] but few studies focus on its appropriateness. Appropriate use of medical imaging was surveyed in two Spanish hospitals which revealed that almost half of imaging was inappropriate which is somewhat similar to our result [6].…”

Problems of thoracic trauma: pulmonary contusion

“…Травми грудної клітки щодня трапляються у 12 з 1 млн американ-ців і безпосередньо пов'язані з 20-25 % усіх смертей від травми, що становить приблизно 16 000 смертей у США щороку. Отже, в умовах воєнного стану через збільшення ризику виникнення травматичних ушкоджень покращення медичної допомоги пацієнтам з торакальною травмою є актуальною проблемою [1][2][3].…”

“…Проте виявлення змін при рентгенографії грудної клітки через 24 год повинне викликати підозру й щодо іншої патології, такої як аспірація, пневмонія та жирова емболія. За допомогою спіральної комп'ютерної томографії забій виявляється вже при початковому дослідженні в умовах відділення невідкладної медичної допомоги [2,3,7].…”

“…Забита легеня зазвичай оточена ділянкою набряку. Накопичення рідини в альвеолах спричиняє заповнення альвеол білками й альвеолярний колапс [2,4,5].…”