Thoracic injuries in trauma patients: epidemiology and its influence on mortality.

Autor: Lundin A; Department of Trauma, Acute Surgery and Orthopaedics, Karolinska University Hospital, 171 64, Stockholm, Sweden. andrea.lundin@regionstockholm.se.; Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. andrea.lundin@regionstockholm.se., Akram SK; Department of Trauma, Acute Surgery and Orthopaedics, Karolinska University Hospital, 171 64, Stockholm, Sweden.; Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden., Berg L; Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.; School of Health and Welfare, Dalarna University, Falun, Sweden., Göransson KE; Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.; School of Health and Welfare, Dalarna University, Falun, Sweden., Enocson A; Department of Trauma, Acute Surgery and Orthopaedics, Karolinska University Hospital, 171 64, Stockholm, Sweden.; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Jazyk: angličtina
Zdroj: Scandinavian journal of trauma, resuscitation and emergency medicine [Scand J Trauma Resusc Emerg Med] 2022 Dec 12; Vol. 30 (1), pp. 69. Date of Electronic Publication: 2022 Dec 12.
DOI: 10.1186/s13049-022-01058-6
Abstrakt: Background: Thoracic injuries are common among trauma patients. Studies on trauma patients with thoracic injuries have reported considerable differences in morbidity and mortality, and there is limited research on comparison between trauma patients with and without thoracic injuries, particularly in the Scandinavian population. Thoracic injuries in trauma patients should be identified early and need special attention since the differences in injury patterns among patient population are important as they entail different treatment regimens and influence patient outcomes. The aim of the study was to describe the epidemiology of trauma patients with and without thoracic injuries and its influence on 30-day mortality.
Methods: Patients were identified through the Karolinska Trauma Register. The Abbreviated Injury Scale (AIS) system was used to find patients with thoracic injuries. Logistic regression analysis was performed to evaluate factors [age, gender, ASA class, GCS (Glasgow Coma Scale), NISS (New Injury Severity Score) and thoracic injury] associated with 30-day mortality.
Results: A total of 2397 patients were included. Of those, 768 patients (32%) had a thoracic injury. The mean (± SD, range) age of all patients (n = 2397) was 46 (20, 18-98) years, and the majority (n = 1709, 71%) of the patients were males. There was a greater proportion of patients with rib fractures among older (≥ 60 years) patients, whereas younger patients had a higher proportion of injuries to the internal thoracic organs. The 30-day mortality was 11% (n = 87) in patients with thoracic injury and 4.3% (n = 71) in patients without. After multivariable adjustment, a thoracic injury was found to be associated with an increased risk of 30-day mortality (OR 1.9, 95% CI 1.3-3.0); as was age ≥ 60 years (OR 3.7, 95% CI 2.3-6.0), ASA class 3-4 (OR 2.3, 95% CI 1.4-3.6), GCS 1-8 (OR 21, 95% CI 13-33) and NISS > 15 (OR 4.2, 2.4-7.3).
Conclusion: Thoracic injury was an independent predictor of 30-day mortality after adjustment for relevant key variables. We also found a difference in injury patterns with older patients having a higher proportion of rib fractures, whilst younger patients suffered more internal thoracic organ injuries.
(© 2022. The Author(s).)
Databáze: MEDLINE
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