Factors Affecting Mortality in Blunt Thoracic Trauma

Hasbahçeci, Mustafa; Özpek, Adnan; Başak, Fatih; Çalışkan, Müjgan; Ener, Behcet Kemal; Ali̇moğlu, Orhan

doi:10.5505/tjtes.2013.54782

Cited by 8 publications

(10 citation statements)

References 16 publications

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“…Chrysou et al [8] reported an overall mortality rate of 5.5% (6 in 110 patients) and stated that there was a significant association between mortality rate and ISS, as all 6 deaths were in the group with an ISS >24. Liman et al [6] and Hasbahçeci et al [17] also noted that mortality increased with an increasing ISS. Segers et al [21] reported an overall mortality rate of 16.6% and an average ISS of 27.8 in their study that included 187 cases of thoracic trauma.…”

Section: Discussionmentioning

confidence: 94%

“…Common associated injuries include spine injuries, extremity fractures, abdominal injuries, and head trauma. [17] In the study conducted by Chrysou et al, [8] the most common co-existing extra-thoracic injuries were extremity fractures, spine injuries, and head trauma, with an incidence rate of 76.4%, 53.6%, and 37.3%, respectively. Freixinet et al [12] reported a rate of 19.1% for extra-thoracic trauma, and mentioned that limb fracture was the most common pathology, with an incidence of 28.7%.…”

Section: Discussionmentioning

confidence: 98%

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A pathology not be overlooked in blunt chest trauma: Analysis of 181 patients with bilateral pneumothorax

Özdil

Kavurmacı²,

Akçam³

et al. 2018

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Bilateral pneumothorax (BPTx) can become tension PTx and a cause of mortality, especially in severe multi-trauma patients. The purpose of this study was to analyze the incidence, morbidity, mortality, and associated factors of BPTx in multi-trauma patients in order to highlight the importance of the management of these cases, as well as complications, morbidity, and mortality. METHODS: The data of 181 patients with BPTx, from a total of 3782 trauma patients, were reviewed retrospectively. The details recorded were age, gender, mechanism of trauma, radiological findings, co-existing thoracic and extra-thoracic injuries, incidence of intubation, mortality, and injury severity score (ISS). The association between laterality of rib fracture, hemothorax, subcutaneous emphysema, and BPTx, and the effect of age and gender on these injuries, mortality, and ISS were analyzed. RESULTS: The patient group included 144 males, and the mean age was 36.07±15.77 years. The primary cause of trauma was a motor vehicle accident, seen in 67 (37.0%) patients. Bilateral rib fractures were detected in 75 (41.4%) patients. Hemothorax accompanied PTx in 41 (22.6%) patients bilaterally. The laterality of the rib fracture and hemothorax demonstrated a significant difference in the patient group over 60 years of age (p=0.017, p=0.005). Co-existing bilateral thoracic injuries were detected more often in this group. Twelve (17.6%) patients with only blunt chest trauma and 56 (82.4%) patients with multi-trauma were intubated. The difference between the 2 groups was not significant (p=0.532). The overall mortality rate was 18.2%. A comparison of ISS and mortality between the groups revealed no significant difference (p=0.22). CONCLUSION: The incidence of BPTx after multi-trauma is approximately 5%, so it must be taken into consideration, especially in severe multi-trauma patients, to reduce mortality. Older age and the number of rib fractures were determined to be risk factors for morbidity and mortality in trauma with BPTx.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 98%

A pathology not be overlooked in blunt chest trauma: Analysis of 181 patients with bilateral pneumothorax

Özdil

Kavurmacı²,

Akçam³

et al. 2018

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

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“…Clavicular, extremity, and abdominal injuries are other injuries that may be seen accompanying SF. Previous studies reported upper extremity fractures (17%-37%), lower extremity fractures (8%-26%), and abdominal organ injuries (3%-13%) together with SF (21)(22)(23)(24). In the current study, upper extremity fractures accompanying SF were determined at 24.7%, lower extremity fractures at 11.7%, clavicular fracture at 12.9%, and abdominal organ injuries at 9.1%.…”

Section: Discussionmentioning

confidence: 52%

The relation between scapula fracture and the severity of trauma in blunt thoracic trauma

et al. 2018

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Blunt thoracic trauma patients constitute 20% of traumarelated deaths (1). Scapula fracture (SF) generally occurs as a result of high-energy trauma and is usually seen together with significant organ or system injuries. When SF is determined there could also be damage to other organs and systems, primarily the thorax (2-4). In patients with trauma, the injury severity score (ISS) is associated with the severity of the trauma. The values of ISS representing trauma severity are stated as 0-8 = minor, 9-15 = moderate, 16-24 = quite severe, and >24 = severe (5). SF may often not be able to be initially identified on chest radiography. This may be due to the inadequate quality of radiographic imaging or that differentiation may not be able to be clearly made of radiographic images associated with thoracic damage (subcutaneous emphysema, pulmonary contusion, pneumothorax) (6,7). However, in the presence of life-threatening injuries in patients with SF, evaluation of the scapula may take second place and may cause the physician evaluating the patient to not recognize the fracture. In cases with thoracic trauma in particular, despite scapula injury not being considered in the physical examination or on radiographs, the determination of SF on computerized tomography (CT) is noticeable (7-10). In recent years, there has been increased use of CT in trauma patients due to the more easy availability of technology, increasing defensive medical practices, and concerns about malpractice. Therefore, according to previous studies, in patients with blunt thoracic trauma, when accompanying injuries and the energy level of the trauma are taken into consideration, there could be several differences. The aim of our study was to determine the level of presence of SF in cases of blunt thoracic trauma and to identify other injuries, particularly thoracic injuries, accompanying SF. 2. Materials and methods 2.1. Study design Approval for the study was granted by the local ethics committee (No. 2016-04/01). A retrospective study was made of patients who presented to the Emergency Department (ED) of Kırıkkale University Hospital Background/aim: The aim of this study was to determine the level of presence of scapula fractures (SFs) in cases of blunt thoracic trauma and to identify other injuries accompanying SF. Materials and methods: Blunt thoracic trauma cases with SF determined on direct radiography or computerized tomography (CT) were categorized as Group 1. Group 2 was constituted by selecting cases with high injury severity score (ISS) with no SF. The demographic characteristics and all injuries of the patients were evaluated. Results: SF was determined in 77 (11.3%) patients (Group 1), and Group 2 consisted of 607 patients. The ISS was significantly higher in Group 1 (27.7 ± 16.1) than Group 2 (15.9 ± 9.5) (P < 0.001). The rate of SF with direct radiography was only 9.1%, and more than 90% of patients were evaluated using CT. The most common accompanying injury to SF was rib fracture (44.2%), and the odds ratio was 2.4 (95% CI: 1.51-3.7...

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“…In another study conducted in our country, low systolic blood pressure during hospitalization was found to be important for mortality and morbidity [14]. In Hasbahçeci et al's study [15], low systolic blood pressure and apneic breathing were found to be effective on mortality. In our study; the relationship between mortality, high pulse rate and low oxygen saturation is remarkable in GSW patients with high mortality rates.…”

Section: Discussionmentioning

confidence: 88%

Comparison of penetrating thoracic traumas in patients with gunshot and stab wounds in an emergency department

Saylam

Gürsoy

Şahin

et al. 2020

The European Research Journal

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Objectives: Thoracic trauma is among the most important causes of mortality in emergency departments. In this study of penetrating stab wounds (PSWs) and gunshot wounds (GSWs) admitted to the emergency department with penetrating thoracic trauma cases clinical findings, emergency treatment approaches and survivals were compared with literature information. Methods: One hundred fifty-two patients who applied to Bakırköy Dr. Sadi Konuk Training and Research Hospital Emergency Department with penetrating thoracic trauma on 1 January 2014 and 31 December 2014 were evaluated retrospectively the patients. SPSS 22.0, NY, USA program was used in the analyzes. Results: Patients administered with PSW were 79.6%, with GSW were 20.4%. Patients in the group GSW were admitted to the emergency department with more serious symptoms than patients in the group PSW (Triage level 2, GSW: 87.1%, PSW: 62.8% and Triage level 3, GSW: 12.9% vs. PSW: 37.2%), (p = 0.010). Hemothorax (25.8%) in PSW patients and pneumothorax (40.5%) in GSW patients was detected more frequently. Surgical treatment was performed in 14.9% of patients with PSW, tube thoracostomy was performed in 24%, and 62.82% were treated with conservative treatment. Surgical treatment was performed in 35.5% of GSW patients and tube thoracostomy was performed in 29%, and 48.4% were treated with conservative treatment (p > 0.05). Conclusion: Despite the lower incidence of GSW than PSW in emergency departments, GSW require more surgical intervention and have a higher mortality rate.

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Factors Affecting Mortality in Blunt Thoracic Trauma

Cited by 8 publications

References 16 publications

A pathology not be overlooked in blunt chest trauma: Analysis of 181 patients with bilateral pneumothorax

A pathology not be overlooked in blunt chest trauma: Analysis of 181 patients with bilateral pneumothorax

The relation between scapula fracture and the severity of trauma in blunt thoracic trauma

Comparison of penetrating thoracic traumas in patients with gunshot and stab wounds in an emergency department

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