Approximately 20-25% of deaths due to trauma in the first four decades of life result from thoracic trauma [1]. Penetrating thoracic trauma is present in 33% of deaths due to thoracic trauma [2]. in a 1972 autopsy study involving 1178 trauma patients, 82% of the patients with tracheobronchial injuries died at the accident site; 30% of those who could come to the hospital also died. it was observed that 50% of these losses occurred in the first hour [3].Between 2001 and 2005, a total of 1033 tracheal injuries were reported over five years in Germany [4]. According to the US Centers for Disease Control and Prevention (CDC), while the medical costs of approximately 12 000 patients who died in 2005 due to firearm assault injury were more than $60 million, it was reported that the loss of work and productivity was 18 billion dollars. Between 2000 and 2005, the average hospital cost for adults over the age of 18 who had a penetrating injury was estimated at £7983 in the UK [5]. it was observed that mortality in thoracic trauma patients was 36% before 1950 and decreased to 9% after 1970 [6].
Purpose: In this study, we aimed to evaluate the laboratory markers used in the diagnosis of COVID-19 and to present the parameters that can be used to predict mortality. Material and method: The cases followed in the intensive care unit due to COVID-19 in our clinic between March 2020 and December 2020 were evaluated retrospectively. A total of 374 patients who met the study criteria were included in the study. The patients were divided into two groups as the patients who were discharged from the intensive care unit with no mortality and patients with a mortal course. Patients with no mortality constituted Group- 1, and patients with a mortal course constituted Group- 2. Demographic, clinical, and laboratory characteristics of the patients were compared. Results: The number of patients in group- 1 consisting of patients with no mortality was 148 (39.5%), and the number of patients in group- 2 consisting of patients with mortality was 226 (60.4%). In the group of patients without mortality, 84 (56.8%) of the patients were male, while in the mortality group, 127 (56.2%) were male. In the mortality group, procalcitonin, CRP, BUN, D-dimer, troponin, LDH, lactate, and INR values were higher, albumin value was lower, and this difference was statistically significant (p< 0.001). In the logistic regression analysis, PLT and D-dimer were found as the independent variables of mortality. Conclusion: We think that the high procalcitonin and D-dimer values obtained with routinely examined rapid
Hemothorax occurs due to various conditions such as trauma, malignancy, tuberculosis, bullous lung disease, and lung abscess. In patients with malignant hemothorax, stabilization of the clinical condition and treatment of primary disease is of primary importance. A 53-year-old female patient, who had a history of surgery for ovarian cancer and liver metastasis, admitted to the hospital with complaints of shortness of breath. The patient was found to have pleural effusion on the right hemithorax, and a tube thoracostomy was performed. During the clinical follow-up, the amount of drainage did not decrease. Thereby, the patient underwent a video-thoracoscopic evaluation, and chemical pleurodesis was applied intraoperatively. Despite chemical pleurodesis, hemorrhagic drainage continued. Intrapleural tranexamic acid administration was performed to ensure the stabilization of the clinical condition. Immediately days after the intrapleural application of tranexamic acid, the drainage of the fluid decreased and became sero-hemorrhagic. The management of this case made us think that intrapleural tranexamic acid may be an alternative in persistent malign hemothorax.
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