Factors Affecting Mortality and Morbidity After Traumatic Diaphragmatic Injury

Özgüç, Halil; Akköse, Şule; Şen, Gürol; Bulut, Mehtap; Kaya, Ekrem

doi:10.1007/s00595-007-3545-1

Cited by 20 publications

(17 citation statements)

References 11 publications

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“…The factors affecting the mortality and morbidity in surgery have been widely studied. 2,3 In addition, the ICU readmission during the same hospitalization, which has been identifi ed as an important indicator for the quality of care, also serves as a reliable performance indicator in intensive care. The premature discharge from the ICU (readmission <48 h) and substandard care in the general wards may also contribute to readmission.…”

Section: Introductionmentioning

confidence: 99%

Readmission to the intensive care unit: An indicator that reflects the potential risks of morbidity and mortality of surgical patients in the intensive care unit

et al. 2009

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Section: Introductionmentioning

confidence: 99%

Readmission to the intensive care unit: An indicator that reflects the potential risks of morbidity and mortality of surgical patients in the intensive care unit

et al. 2009

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“…Mortality rates for diaphragm injuries have been reported in the literature as 10-35%. [27,29,30] In the current series, mortality was determined at the rate of 17%; in 3/32 patients with penetrating injuries and in 4/9 of those with blunt trauma. In five of these cases, mortality was due to hemorrhagic shock, and in two cases, to organ failure (generally associated with concomitant injuries).…”

Section: Discussionmentioning

confidence: 88%

Factors affecting mortality in traumatic diaphragm ruptures

Tokgöz¹

2019

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Traumatic diaphragm ruptures (TDR) are rarely seen. Although TDR does not cause morbidity in the acute period, undiagnosed TDR may cause clinical states, such as herniation, strangulation, pneumonia, pleural effusion, empyema, and cardiac tamponade, which have high morbidity and mortality rates in the late period. This study aims to evaluate the epidemiology, clinical characteristics, diagnosis and treatment methods of TDR encountered in thoracoabdominal trauma and to identify the factors affecting mortality. METHODS:A retrospective examination was carried out on the patients who were operated in our clinic because of traumatic diaphragm injury between January 2012 and December 2017. Each patient operated because traumatic diaphragm injury was evaluated in respect of age, gender, manner of injury, preoperative examination findings, laboratory test results, imaging methods, time of diagnosis, operation findings, concomitant injuries to other organs, operations performed, length of stay in hospital, the development of postoperative morbidity and mortality, and the calculated Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). RESULTS:Between January 2012 and December 2017, a total of 1066 patients were operated in our clinic because of thoracoabdominal trauma, and of 1066 patients, 45 of the patients were determined with TDR. Of the 45 patients, surgery was applied because of penetrating trauma in 32 cases (7 firearms injuries, 25 penetrating cutting injuries), blunt trauma in nine cases, and in four cases, diaphragm rupture was seen to have developed associated with iatrogenic injury during an operation. The most common injuries concomitant to traumatic diaphragm rupture were hemopneumothorax (70%), liver (43%), spleen (32%), colon (20%), stomach (17%) injuries and rib fractures (15%), respectively. Mortality developed in seven (17%) patients; five patients were lost because of hemorrhagic shock intraoperatively or in the early postoperative hours, and two because of multiorgan failure during follow-up in the intensive care unit. CONCLUSION:In high energy blunt and penetrating thoracoabdominal traumas, diaphragm injuries should be suspected. Factors affecting mortality were found to be the AISS, ISS, number of concomitant organ injuries and the combination with pneumohemothorax.

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“…However, blunt torso trauma is often associated with a higher frequency of extra-abdominal injury. 10 Therefore, the physician searched for other extra-abdominal injuries, such as cardiac tamponade, cardiac rupture, tension pneumothorax, or cardiac contusion with fatal dysrhythmia, as the cause of the traumatic cardiac arrest. Cardiac tamponade, cardiac rupture, or tension pneumothorax were easily ruled out with an image study and physical examination in this case.…”

Section: Discussionmentioning

confidence: 99%

Commotio cordis as a rare cause of traumatic cardiac arrest in motorbike crashes: Report of a case

et al. 2010

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It is futile to attempt resuscitation in a blunt injury patient with no vital signs upon arriving at the emergency department. Therefore, it is recommended that resuscitation be withheld in any blunt trauma patient without vital signs while emergency medical technicians arrive at the scene of the accident. This report presents a case of a blunt torso trauma patient who lost vital signs at the scene and still received cardiopulmonary resuscitation until recovery of spontaneous circulation at the emergency department. The patient was later diagnosed with commotio cordis, and survived to be discharged without any neurological sequelae. Therefore, aggressive resuscitation should be continued until a diagnosis and differential diagnosis of blunt trauma-related cardiac arrest are made by a thorough examination in the emergency department.

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Factors Affecting Mortality and Morbidity After Traumatic Diaphragmatic Injury

Abstract: Establishing a preoperative diagnosis of DI is still problematic. Aggressive treatment and close monitoring of patients with an ISS > 13, an RTS < or = 11, an age > or = 48 years, or a postoperative complication may decrease morbidity and mortality.

Cited by 20 publications

References 11 publications

Readmission to the intensive care unit: An indicator that reflects the potential risks of morbidity and mortality of surgical patients in the intensive care unit

Readmission to the intensive care unit: An indicator that reflects the potential risks of morbidity and mortality of surgical patients in the intensive care unit

Factors affecting mortality in traumatic diaphragm ruptures

Commotio cordis as a rare cause of traumatic cardiac arrest in motorbike crashes: Report of a case

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