The factors affecting the morbidity and mortality in chest trauma

BACKGROUND: We evaluated thoracic trauma cases with respect to etiologic causes, other system injuries accompanying to the thoracic trauma, treatment methods and outcomes and the prognostic factors affecting the need for thoracotomy, length of hospital stay, morbidity and mortality in the light of relevant literature data. METHODS: A retrospective evaluation was performed on 141 patients (102 males (72.3%), 39 females (27.7%); mean age 40; range 8 to 89 years) who were treated for thoracic trauma in our center between July 2003 and December 2005. RESULTS: 117 patients (83%) had blunt and 24 (17%) penetrating thoracic trauma. Isolated thoracic trauma and multisystem trauma were found in 48 (34%) and 93 (66%) patients, respectively. Mean white blood cell count was 12.560±5.7 (5-25x103 /uL) at admission. The number of patients who met lung injury scale criteria for grade I, grade II, grade III and grade IV were 19 (13.5%), 12 (8.5%), 25 (17.7%) and 13 (9.2%), respectively. Hypotension was determined in 16 patients (11.3%) during admission. With regard to treatment, while symptomatic conservative management was satisfactory in 76 patients (53.9%), tube thoracoscopy and thoracotomy were performed in 59 (41.8%) and 11 (7.8%) patients respectively. The morbidity was seen in 30 patients (21.3%). The mortality rate was 7.8% (n=11). CONCLUSION: The high white blood cell count, high lung injury scale grade, 3 and more rib fractures and accompanying head injury were determined as the prognostic factors affecting the morbidity and mortality.

Göðüs travmasýnda morbidite ve mortaliteyi etkileyen faktörler

AMAÇ: Göðüs travmasýna yol açan nedenler, eþlik eden diðer sistem yaralanmalarý, tedavi yöntemleri ve sonuçlar ile birlikte torakotomi ihtiyacý, hastanede kalýþ süresi, morbidite ve mortaliteyi etkileyen prognostik faktörler literatür bilgileri eþliðinde deðerlendirildi. GEREÇ-YÖNTEM: Temmuz 2003-Aralýk 2005 tarihleri arasýnda merkezimizde tedavisi yapýlan göðüs travmalý 141 olgu (102 erkek (%72.3), 39 kadýn (%27.7); ortalama yaþ 40; daðýlým 8-89) geriye dönük olarak deðerlendirildi. BULGULAR: Olgularýn 117'sinde (%83) künt ve 24'ünde (%17) penetran göðüs travmasý vardý. Olgularýn 48'inde (%34) izole göðüs travmasý, 93'ünde (%66) multisistem travma saptandý. Baþvuru anýnda kanda lökosit sayýsý ortalama 12.560±5.7 (5- 25x103/uL ) idi. Akciðer yaralanma skalasý 19 olguda (%13.5) grade I, 12 olguda (%8.5) grade II, 25 olguda (%17.7) grade III ve 13 olguda (%9.2) grade IV idi. Baþvuru anýnda hipotansiyon 16 olguda (%11.3) vardý. Tedavide 76 olguda (%53.9) semptomatik tedavi yeterli olurken, 59'unda (%41.8) tüp torakostomi, 11'inde (%7.8) torakotomi uygulandý. Morbidite 30 olguda (%21.3) mevcuttu. Mortalite oraný %7.8 idi. SONUÇ: Lökositoz, yüksek evre akciðer yaralanma skalasý grade'i, 3 veya daha fazla kot kýrýðý ve eþlik eden kafa travmasý morbidite ve mortaliteyi etkileyen prognostik faktörler olarak saptandý.