| Autor: |
M. Reymond, M. Beshay, Branscheid D, Kottkamp Hw, F Mertzlufft, Vordemvenne T, Schmid Ra |
| Rok vydání: |
2020 |
| Předmět: |
|
| Popis: |
Objectives:Thoracic trauma (TT) is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. Its management is still a very challenging task. The purpose of this study was to analyse the epidemiological finding, risk factors affecting the outcome in a high volume trauma centre.Patients and methods:Between January 2003 and December 2012 data of all patients admitted to the Accident and Emergency (A&E) were prospectively collected at the German Trauma Registry (GTR) thereafter retrospectively analysed.Patients with chest trauma and Injury Severity Score (ISS) ≥18 and Abbreviated Injury Scale (AIS) >2 in more than one body region were included. Patients were divided into two groups; group I included patients with thoracic trauma between January 2003 to December 2007. The results of this group were compared with the results of other group (group II) in a later five years period (Jan. 2008-Dec. 2012). Univariate and multivariate analysis was done, Statistical difference with PResults:There were 630 patients (56%) with thoracic trauma. 540 patients (48%) had associated extra thoracic injuries. Group I consisted of 285 patients (197 male, mean age 46 years). Group II consisted of 345 patients (251 male, mean age 49 year). Overall 90 days mortality was 17% (n=48) in group I vs. 9% (n=31) in group II (p=0.024). Complication rates were higher in group I (p=0.019). Higher injury severity score (ISS), and higher abbreviated injury score (AIS) thoracic showed higher rate of mortality (pp=0.014). Patients with severe lung contusions (n=94) (15%) had higher morbidity and mortality (pp=0.041). Organ replacement procedures were needed in 18% in group I vs. 31% in group II (p=0.038).Conclusions:The presence of severe lung contusion, higher ISS and AISthoracic and advanced age are directly related to higher mortality rate. Instantly management of blunt chest trauma with corrected chest tube insertion, optimal pain control and chest physiotherapy resulted in good outcome in the majority of patients. Optimal management with better survival rates is achievable in specialized centre with a multidisciplinary teamwork and the presence of thoracic surgical experience. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
