Predictors of Outcome in Blunt Chest Trauma

Autor: B. Virgós Señor, A.C. Nebra Puertas, M. A. Suarez Pinilla, A. Broto Civera, C. Sánchez Polo
Rok vydání: 2004
Předmět:
Zdroj: Archivos de Bronconeumología ((English Edition)). 40:489-494
ISSN: 1579-2129
DOI: 10.1016/s1579-2129(06)60363-7
Popis: Introduction Thoracic trauma is often associated with polytrauma. Because mortality is high, the search for prognostic tools is useful. Patients and methods A total of 108 patients with blunt thoracic trauma, 73 of whom had multiple injuries, were studied in an intensive care unit (ICU). The variables named as potential predictors of outcome were the need for mechanical ventilation, duration of ventilation, and high positive end-expiratory pressure (PEEP); the presence of rib fractures, pulmonary contusion, pleural involvement (hemo-and/or pneumothorax), or lung infection; the need for emergency surgery; mean duration of ICU stay, and age. We also studied whether or not the mortality rate was higher in polytrauma patients. Student t and CH2 tests (95% confidence level) and multiple regression analysis (Hosmer-Lemeshow goodness of fit) were used to analyze the results. Results The need for mechanical ventilation, radiographic evidence of pulmonary contusion, emergency surgery, and hemodynamic instability were risk factors for increased mortality. Higher risk of mortality was not demonstrated for patients with multiple injuries. For patients in need of mechanical ventilation, high PEEP was a predictor of poor prognosis. Conclusions The presence of the aforementioned predictors (mechanical ventilation, high PEEP, pulmonary contusion, emergency surgery, and hemodynamic instability) indicate serious injury to the lung parenchyma, which is the main determinant of outcome for patients with thoracic trauma.
Databáze: OpenAIRE
načítá se...