Predictors of Outcome in Blunt Chest Trauma

Señor, B. Virgós; Puertas, Agustín Carlos Nebra; Polo, C. Sánchez; Civera, Alicia; Pinilla, Miguel

doi:10.1016/s1579-2129(06)60363-7

Cited by 14 publications

(5 citation statements)

References 18 publications

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“…In our study, the overall mortality rate was 18.2%, and 97% of those patients were in the intubated patient group. The difference between the isolated thorax trauma patients and multi-trauma patients was not significant in terms of mortality, a finding similar to the result obtained in the study of Virgós Señor et al [20] We found that the mortality rate increased when the hospital stay was shorter. This difference may be related to the fact that most of the deaths occurred in the early period of admission due to fatal pathologies such as brain injury.…”

Section: Discussionsupporting

confidence: 91%

“…This may be due to the fact that all of the patients in our study had BPTx. Virgós Señor et al [20] reported a higher incidence rate than that of our study, which may have been because their study included trauma patients in an ICU. Furthermore, there was not a significant difference between the isolated BCT and the multi-trauma patients groups in our study, but the mortality rate was significantly higher in the intubated patient group, which is also consistent with the literature.…”

Section: Discussioncontrasting

confidence: 73%

“…They reported a mortality rate that increased to 30.4% in patients with PTx. Virgós Señor et al [20] mentioned that mortality had occurred all in patients in need of MV and reported that they had not seen a higher mortality rate among polytrauma patients in their studies, even those with head and brain injury. Chrysou et al [8] reported an overall mortality rate of 5.5% (6 in 110 patients) and stated that there was a significant association between mortality rate and ISS, as all 6 deaths were in the group with an ISS >24.…”

Section: Discussionmentioning

confidence: 97%

“…The incidence rate of intubation and MV was reported as 6.9% in 1772 trauma cases by Freixinet et al [12] and was stated to be a poor prog-nostic factor for multiple injury and cardiorespiratory repercussions. Virgós Señor et al [20] noted that MV was a significant factor for death in BCT patients and reported an incidence rate of 81.5% in 108 multi-trauma patients. The authors did not report any significant differences in terms of multiple trauma, head/brain injury, or PTx between the patients who did and did not require MV.…”

Section: Discussionmentioning

confidence: 99%

“…The overall mortality in polytrauma patients with BCT varies between 2.4% and 33.3%. [2,[4][5][6][7][8]11,12,[18][19][20][21] The factors associated with survival include the severity of the BCT and co-existing injuries, especially neurotrauma. [8,21] Di Bartolomeo et al [11] reported an overall mortality rate of 23.3% in their study comprising 446 major trauma patients.…”

Section: Discussionmentioning

confidence: 99%

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A pathology not be overlooked in blunt chest trauma: Analysis of 181 patients with bilateral pneumothorax

Özdil

Kavurmacı²,

Akçam³

et al. 2018

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Bilateral pneumothorax (BPTx) can become tension PTx and a cause of mortality, especially in severe multi-trauma patients. The purpose of this study was to analyze the incidence, morbidity, mortality, and associated factors of BPTx in multi-trauma patients in order to highlight the importance of the management of these cases, as well as complications, morbidity, and mortality. METHODS: The data of 181 patients with BPTx, from a total of 3782 trauma patients, were reviewed retrospectively. The details recorded were age, gender, mechanism of trauma, radiological findings, co-existing thoracic and extra-thoracic injuries, incidence of intubation, mortality, and injury severity score (ISS). The association between laterality of rib fracture, hemothorax, subcutaneous emphysema, and BPTx, and the effect of age and gender on these injuries, mortality, and ISS were analyzed. RESULTS: The patient group included 144 males, and the mean age was 36.07±15.77 years. The primary cause of trauma was a motor vehicle accident, seen in 67 (37.0%) patients. Bilateral rib fractures were detected in 75 (41.4%) patients. Hemothorax accompanied PTx in 41 (22.6%) patients bilaterally. The laterality of the rib fracture and hemothorax demonstrated a significant difference in the patient group over 60 years of age (p=0.017, p=0.005). Co-existing bilateral thoracic injuries were detected more often in this group. Twelve (17.6%) patients with only blunt chest trauma and 56 (82.4%) patients with multi-trauma were intubated. The difference between the 2 groups was not significant (p=0.532). The overall mortality rate was 18.2%. A comparison of ISS and mortality between the groups revealed no significant difference (p=0.22). CONCLUSION: The incidence of BPTx after multi-trauma is approximately 5%, so it must be taken into consideration, especially in severe multi-trauma patients, to reduce mortality. Older age and the number of rib fractures were determined to be risk factors for morbidity and mortality in trauma with BPTx.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

A pathology not be overlooked in blunt chest trauma: Analysis of 181 patients with bilateral pneumothorax

Özdil

Kavurmacı²,

Akçam³

et al. 2018

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

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Lung Sparing Damage Control Surgery for Major Thoracic Trauma—A 5-year Experience*

Hanif¹,

Mirza²,

Chaudhry

2006

Eur J Trauma

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Effect of vitamin C and vitamin E on lung contusion: A randomized clinical trial study

Davoodabadi

Taheri

Saba

et al. 2018

Annals of Medicine and Surgery

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There is association between lung contusion (lC) and a progressive inflammatory response. The protective effect of vitamin C and vitamin E, as strong free radical scavengers on favourite outcome of (LC) in animal models, has been confirmed.Designto evaluate the effect of vitamins, E and C on arterial blood gas (ABG) and ICU stay, in (LC), with injury severity score (ISS) 18 ± 2, due to blunt chest trauma.MethodsThis study was a randomized, double-blind, placebo-controlled clinical trial. Patients with (ISS) 18 ± 2 blunt chest trauma, who meet criteria, participated in the study. A total of 80 patients from Feb 2015 to Jun2018and were randomly divided into 4 groups. Patients received intravenous vitamin E (1000IU mg), was (group I); intravenous vitamin C (500) (group II). Vitamin C + vitamin E = (group III), and intravenous distilled water = (control group) or (group IV). ABG, serum cortisol, and CRP levels were determined at baseline, 24 h and 48 h after the intervention.Resultsa significant decrease in ICU stay in group III compared to other groups (p < 0.001). Co-administration of vitamin C and vitamin E showed significant increases pH (values to reference range from acidemia”), oxygen pressure, and oxygen saturation in group III compared to other groups (p < 0.001). A significant decrease in carbon dioxide pressure was also detected after receiving vitamin C and vitamin E in group III, compared to other groups (p < 0.001). There was no significant difference cortisol and CRP levels between groups after the intervention.ConclusionCo-administration of vitamin C and vitamin E, improve the ABG parameters and reduce ICU stay.

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Predictors of Outcome in Blunt Chest Trauma

Cited by 14 publications

References 18 publications

A pathology not be overlooked in blunt chest trauma: Analysis of 181 patients with bilateral pneumothorax

A pathology not be overlooked in blunt chest trauma: Analysis of 181 patients with bilateral pneumothorax

Lung Sparing Damage Control Surgery for Major Thoracic Trauma—A 5-year Experience*

Effect of vitamin C and vitamin E on lung contusion: A randomized clinical trial study

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