Impact of blunt pulmonary contusion in polytrauma patients with rib fractures
| Autor: | Ashar Ata, Marcel Tafen, Steven C. Stain, Pallavi Nadendla, Kimberly Owens, Lauren L. Evans, Daniel J. Bonville, Carl Rosati, Ashley Pfaff, Claire P. Miller, Allan Stolarski |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Rib Fractures Contusions New York Wounds Nonpenetrating Risk Assessment 03 medical and health sciences 0302 clinical medicine Blunt Injury Severity Score Trauma Centers medicine Humans Lung business.industry Multiple Trauma Trauma center 030208 emergency & critical care medicine General Medicine Lung Injury Middle Aged medicine.disease Polytrauma Empyema Icu admission Pulmonary contusion Pneumonia medicine.anatomical_structure 030220 oncology & carcinogenesis Anesthesia Surgery Female business |
| Zdroj: | American journal of surgery. 218(1) |
| ISSN: | 1879-1883 |
| Popis: | Background We investigated the impact of blunt pulmonary contusion (BPC) in patients with rib fractures. Methods Adult patients with rib fractures caused by blunt mechanisms were enrolled over 3 years at a Level 1 trauma center. BPC was defined according to percentage of lung affected as: moderate (1–19% contusion) or severe (≥20% contusion). Results In total, 1448 of the 7238 admitted patients had rib fractures. Of these, 321 (22.2%) had BPC: 236 moderate and 85 severe. Patients with BPC were more likely to be admitted to the ICU (moderate: OR 1.55, 95% CI 1.10–2.19; severe: OR 2.74, 95% CI 1.41–5.32). Significantly increased rates of pneumonia (OR 2.52, 95% CI 1.43–4.90) and empyema (OR 4.80, 95% CI 1.07–21.54) were found for moderate and severe BPC, respectively. Conclusions ICU admission and infectious pulmonary complications were more likely with BPC. The presence of BPC on admission CT is also prognostic of increased resource utilization. |
| Databáze: | OpenAIRE |
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