Lessons from a large trauma center: impact of blunt chest trauma in polytrauma patients-still a relevant problem?

Chrysou, Konstantina; Halat, Gabriel; Hoksch, Beatrix; Schmid, Ralph; Kocher, Gregor (2017). Lessons from a large trauma center: impact of blunt chest trauma in polytrauma patients-still a relevant problem? Scandinavian journal of trauma, resuscitation and emergency medicine, 25(1), p. 42. BioMed Central 10.1186/s13049-017-0384-y

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BACKGROUND Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complications and decrease polytrauma patients' mortality. METHODS In this retrospective study we included all polytrauma patients with blunt chest trauma admitted to our tertiary care center emergency department for a 2-year period, from June 2012 until May 2014. Data collection included details of treatment and outcome. Patients with chest trauma and Injury Severity Score (ISS) ≥18 and Abbreviated Injury Scale (AIS) >2 in more than one body region were included. RESULTS A total of 110 polytrauma patients with blunt chest injury were evaluated. 82 of them were males and median age was 48.5 years. Car accidents, falls from a height and motorbike accidents were the most common causes (>75%) for blunt chest trauma. Rib fractures, pneumothorax and pulmonary contusion were the most common chest injuries. Most patients (64.5%) sustained a serious chest injury (AISthorax 3), 19.1% a severe chest injury (AISthorax 4) and 15.5% a moderate chest injury (AISthorax 2). 90% of patients with blunt chest trauma were treated conservatively. Chest tube insertion was indicated in 54.5% of patients. The need for chest tube was significantly higher among the AISthorax 4 group in comparison to the AIS groups 3 and 2 (p < 0.001). Also, admission to the ICU was directly related to the severity of the AISthorax (p < 0.001). The severity of chest trauma did not correlate with ICU length of stay, intubation days, complications or mortality. CONCLUSION Although 84.5% of patients suffered from serious or even severe chest injury, neither in the conservative nor in the surgically treated group a significant impact of injury severity on ICU stay, intubation days, complications or mortality was observed. AISthorax was only related to the rate of chest tube insertions and ICU admission. Management with early chest tube insertion when necessary, pain control and chest physiotherapy resulted in good outcome in the majority of patients.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Thoracic Surgery
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Thoraxchirurgie

UniBE Contributor:

Hoksch, Beatrix; Schmid, Ralph and Kocher, Gregor

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1757-7241

Publisher:

BioMed Central

Language:

English

Submitter:

Thomas Michael Marti

Date Deposited:

02 Mar 2018 15:32

Last Modified:

04 Mar 2018 02:20

Publisher DOI:

10.1186/s13049-017-0384-y

PubMed ID:

28427480

BORIS DOI:

10.7892/boris.109892

URI:

https://boris.unibe.ch/id/eprint/109892

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