Predictors Of Mortality In Cases With Thoracic Trauma Admitted To The Intensive Care Unit: 10-Year Clinical Outcomes

Abstract

BACKGROUND:Multiple traumas are a leading cause of mortality among young adults worldwide. Thoracic trauma causes approximately 25% of all trauma-associated deaths. This study aims to determine the independent prognostic factors of mortality in cases with thoracic trauma (isolated or with accompanying organ injuries) who were admitted to the intensive care unit (ICU). METHODS:We retrospectively reviewed data from patients with thoracic trauma who were admitted to our ICU between 2007 and 2016. After excluding pediatric patients (aged <18 years), the study sample included 564 cases. From the records, we collected the patients' demographical data, comorbid diseases, primary trauma as an indication for ICU admission, other traumas accompanying thoracic trauma, type of thoracic injury, and therapeutic interventions. The study sample was divided into two subsets: survival and non-survival groups. These two groups were compared with regards to first ICU day laboratory results and intensive care scores, mechanical ventilation times, and ICU stay lengths. RESULTS:Of the 8063 patients admitted to the ICU between 2007 and 2016, 616 (7.6%) had thoracic trauma. The median age (min-max) of the 564 patients eligible for this study was 43 (18-87) years. Mortality occurred in 159 (28.1%) cases, while 405 (71.8%) were discharged from the ICU. Multivariate regression analyses were also performed, in which every increment in age was associated with a 1.025-fold increase in the odds of mortality due to thoracic trauma. Additionally, the presence of central nervous system (CNS) trauma was associated with a 2.147-fold increase, and the presence of pulmonary contusion was associated with a 1.752-fold increase. CONCLUSION:Results of this study indicate that advanced age, the presence of pulmonary contusion, and accompanying CNS trauma are independent predictors of mortality in patients with thoracic trauma in the ICU. Our non-invasive approach is further supported by the trauma and injury severity score (TRISS) scoring system, which is one of the latest scoring systems used in trauma cases.

The Validity of Quantifying Pulmonary Contusion Extent by Lung Ultrasound Score for Predicting ARDS in Blunt Thoracic Trauma

“…We then observed the patients for 28 days, 37 cases were survivors (74%), and 13 patients were nonsurvivors (26%). This outcome is concordant with that of Pehlivanlar et al [ 18 ] who reported that mortality occurred in 159 (28.1%) cases, while 405 (71.8%) were discharged from the ICU. Disagreement to our results Huber et al [ 19 ] who conducted a study on 22613 trauma patients aiming to identify the influence of critical structural damages in patients with blunt chest trauma on mortality; they reported that 82.5% of cases were survivors and 17.5% of cases were nonsurvivors.…”

In-silico investigations of haemodynamic parameters for a blunt thoracic aortic injury case

“…Among all trauma-related fatality, thoracic trauma is the reason of approximately 25% of deaths 1 . Accounting for 1.5% of thoracic trauma, blunt thoracic aortic injury (BTAI) is a rare and mostly fatal disease with in-hospital mortality rate of 46% 2 .…”

IL‑17 is a potential biomarker for predicting the severity and outcomes of pulmonary contusion in trauma patients

“…PC is very common in patients who suffer blunt chest traumas, and the severity of PC ranges from mild to life-threatening ( 3 , 20 ). In the present study, the incidence of blunt chest trauma was 1.9%, and the incidence of PC in these patients was 34.5%, which was similar to previous studies ( 1-3 ).…”