Factors affecting mortality in patients with traumatic diaphragmatic injury: analysis of 92 cases

Kaya, Selçuk; Altin, Onder; Altuntas, Yunus Emre; Ozdemir, Attila; Cesur, Ekin Ezgi; Bildik, Nejdet; Küçük, Hasan Fehmi

doi:10.14744/tjtes.2019.82930

Cited by 5 publications

(6 citation statements)

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Section: Discussionsupporting

confidence: 82%

“…Also in the present study, the liver (29.1%) and spleen (25%) were the intra-abdominal organs most frequently affected by trauma, as they were in a study by Kaya et al, [25] and the ribs (33.3%) were the thoracic organs most frequently affected, as they were in a study by Lim and Park [26] Another important issue in the treatment of DR is pain control. Although simple analgesics are preferred as the first step to control pain in trauma patients, simple analgesics do not work in most cases, increasing the need to use narcotic analgesics.…”

Section: Discussionsupporting

confidence: 78%

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Traumatic diaphragmatic ruptures: A multidisciplinary study in a tertiary health center

İliklerden¹

2022

Turk Gogus Kalp Dama

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 78%

Traumatic diaphragmatic ruptures: A multidisciplinary study in a tertiary health center

İliklerden¹

2022

Turk Gogus Kalp Dama

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Section: Discussionmentioning

confidence: 99%

“…The ratio of patients with a pre-operative hemopneumomediastinum was similar between the groups in our series, and 45% required a thoracostomy during the pre-or intraoperative period. [16][17][18] Most diaphragmatic injuries involve the left diaphragm, since right-side diaphragmatic injuries are relatively rare, given the protective effect of the liver. However, due to the lack of a standardized approach to these injuries, some cases might be overlooked which may provide altered statistical proportions.…”

Section: Discussionmentioning

confidence: 99%

Is diagnostic laparoscopy necessary in the management of left thoracoabdominal stab wounds?

Okmen

2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: The diagnosis of a diaphragmatic rupture and the identification of patients for surgical repair is challenging despite current diagnostic algorithms and imaging technologies. Unless treated on time, acute traumatic diaphragmatic injury due to stab wounds has a high mortality and morbidity rate, with an increasing trend in the presence of organ herniation. In this study, we aimed to investigate the efficacy of diagnostic laparoscopy in patients with an anterior thoracoabdominal stab wound and to compare the follow-up outcomes of cases. METHODS: We retrospectively reviewed our institutional database of patients who were admitted with stab wounds between October 2012 and 2022. Patients who underwent diagnostic laparoscopy were divided into two groups depending on the presence of a diaphragmatic injury. We analyzed demographics, the success of computed tomography (CT) imaging in the diagnosis, the presence of hemomediastinum, pneumomediastinum, tube thoracostomy application, associated organ injury, type of surgery, duration of surgery, complications, and the length of stay between the groups. RESULTS: Of the 39 patients with penetrating left thoracoabdominal injury underwent diagnostic laparoscopy, CT had a diagnostic sensitivity of 63.16% (95% Confidence interval [CI] 38.36–83.71%), and a specificity of 100% (95% CI 82.35–100.00%). We could not find a statistically significant difference between the groups in terms of studied variables, while operation time was significantly higher in the diaphragmatic injury group (P<0.01). Fourteen patients had accompanied visceral injuries. CONCLUSION: Diagnostic laparoscopy is still the gold standard particularly in the ER setting, particularly in the absence of an experienced radiologist for 24 h and when the close monitoring of the patient by the same team cannot be provided.

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“…This could possibly be explained by the hepatic protection on the right side and due to the congenital weakness of the left diaphragm [6]. Even though the prevalence is not precisely known because of the injury being missed due to larger or more critical injuries, it was reported that the incidence is between 1% to 7% in blunt trauma cases and 10% to 15% in cases of penetrating trauma [7]. In a case series that included 57 patients with blunt TDI, the diagnosis of diaphragmatic injury was not made until laparotomy was performed in 42% of patients for the other injuries involved in the trauma [8].…”

Section: Introductionmentioning

confidence: 99%

Incidence of Traumatic Diaphragmatic Injury: Results From a Retrospective Cohort Study in a Level I Trauma Center in Riyadh

Al Babtain,

AlObaid,

Alsogair

et al. 2023

Cureus

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IntroductionTraumatic diaphragmatic injuries (TDIs) are uncommon and the incidence of TDI is difficult to estimate because of the variation in reporting missed or late detected diaphragmatic injuries. Therefore, our study's aim was to investigate the prevalence of traumatic diaphragmatic injury in the thoracoabdominal trauma, discuss the etiological factors, diagnostic investigations, and outcomes in TDIs, and evaluate predictors of mortality in patients who were diagnosed at King Abdulaziz Medical City in Riyadh, Saudi Arabia. Materials and methodsThis observational retrospective cohort study was conducted at King Abdulaziz Medical City (KAMC), a tertiary hospital in Riyadh, Saudi Arabia. The study included all adult patients aged 18 years or older diagnosed with traumatic diaphragmatic injuries between the years 2016 and 2020. The BESTCare electronic system was used to get the patient's medical records and extract the data. Pearson χ2 test was used for categorical variables, and an independent t-test was used for continuous variables to investigate the association between predictors and outcomes. ResultsA total of eight patients were involved in this study. The mean age of the patients was 49 years old. Males outnumbered females by 75%. Patients admitted with blunt injuries were greater by 75% compared to penetrating injuries by 25%. The left side of the diaphragm was the most common site of injury. The total number of patients who were admitted to the ICU was five, four of whom had blunt trauma and one had a penetrating injury. ConclusionThe demographic data of the patients included in this study corresponded to that in the literature. Although not reaching a statistically significant level, ICU admissions and mortality were mostly associated with blunt injuries. Larger multi-center studies are required to further investigate the incidence of traumatic diaphragmatic injuries (TDI).

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Factors affecting mortality in patients with traumatic diaphragmatic injury: analysis of 92 cases

Cited by 5 publications

References 0 publications

Traumatic diaphragmatic ruptures: A multidisciplinary study in a tertiary health center

Traumatic diaphragmatic ruptures: A multidisciplinary study in a tertiary health center

Is diagnostic laparoscopy necessary in the management of left thoracoabdominal stab wounds?

Incidence of Traumatic Diaphragmatic Injury: Results From a Retrospective Cohort Study in a Level I Trauma Center in Riyadh

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