| Autor: |
Waes, O., Riet, P., Lieshout, E., Hartog, D. |
| Předmět: |
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| Zdroj: |
European Journal of Trauma & Emergency Surgery; Oct2012, Vol. 38 Issue 5, p543-551, 9p |
| Abstrakt: |
Background: An emergency department thoracotomy (EDT) or an emergency thoracotomy (ET) in the operating theater are both beneficial in selected patients following thoracic penetrating injuries. Since outcome-descriptive European studies are lacking, the aim of this retrospective study was to evaluate ten years of experience at a Dutch level I trauma center. Method: Data on patients who underwent an immediate thoracotomy after sustaining a penetrating thoracic injury between October 2000 and January 2011 were collected from the trauma registry and hospital files. Descriptive and univariate analyses were performed. Results: Among 56 patients, 12 underwent an EDT and 44 an ET. Forty-six patients sustained one or multiple stab wounds, versus ten with one or multiple gunshot wounds. Patients who had undergone an EDT had a lower GCS ( p < 0.001), lower pre-hospital RTS and hospital triage RTS ( p < 0.001 and p = 0.009, respectively), and a lower SBP ( p = 0.038). A witnessed loss of signs of life generally occurred in EDT patients and was accompanied by 100 % mortality. Survival following EDT was 25 %, which was significantly lower than in the ET group (75 %; p = 0.002). Survivors had lower ISS ( p = 0.011), lower rates of pre-hospital ( p = 0.031) and hospital ( p = 0.003) hemodynamic instability, and a lower prevalence of concomitant abdominal injury ( p = 0.002). Conclusion: The overall survival rate in our study was 64 %. The outcome of immediate thoracotomy performed in this level I trauma center was similar to those obtained in high-incidence regions like the US and South Africa. This suggests that trauma units where immediate thoracotomies are not part of the daily routine can achieve similar results, if properly trained. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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