Emergency Major Surgery in Thoracic Trauma: Timing and Decision Process

Abstract

Background: Surgery is required in 10-15% of patients with thoracic injuries. Surgery performed within the first few hours of the injury is considered as an emergency surgery. The aim of study is to share our experiences with emergency surgical approaches in thoracic trauma. Methods:Our study was carried out between June 2012-June 2020, by retrospective analysis of cases who were evaluated for thoracic trauma in the emergency department and who underwent emergency surgery.Results: There were 5784 patients who requested for thoracic surgery consultation due to thoracic trauma. Of these cases, 1317 (22.8%) were patients who were evaluated in the emergency service due to isolated thoracic trauma. There were 18 patients (1.3%) who underwent emergency surgery for isolated thoracic trauma.Glasgow score was higher in the group that was discharged after recovery among all groups; and this was statistically significant (p= 0.045). It was statistically significant that intubation and low modified trauma scores were a poor prognostic factor (respectively p= 0.035, p=0,025).Conclusions: Tube thoracostomy is sufficient for most of the thoracic traumas. After emergency evaluation, fast and correct decision in the appropriate surgical indication significantly reduces mortality.