Analysis of Patients with Emergency Thoracic Trauma

Abstract

Background: Trauma is an important health problem because it causes high morbidity and mortality. Thoracic trauma is generally categorized as blunt and penetrating trauma. Thoracic traumas are life-threatening and require rapid intervention. Successful treatment is achieved with multidisciplinary management and rapid diagnosis. Aims: It was aimed to investigate clinical outcomes of emergency thoracic trauma in the study. Study Design: Trauma patients older than 18 years old hospitalized to the thoracic surgery clinic from the emergency department were included and, patients were excluded without thoracic trauma, not hospitalized, and younger than 18 years of ages in the study. Place and Duration of Study: Ersin Arslan Training and Research Hospital wards of thoracic surgery from January 1, 2021 to December 31, 2021. Methodology: A total of 114 patients were analyzed. The data of the patients were analyzed ages, gender, comorbidities, smoking, use of alcohol and other substances, types of trauma, localization and variety of injuries, pathological findings on thoracic and extrathoracic organs, methods of medical and surgical treatments, lenght of stays in Intensive-care Unit and hospital, recovery and mortality. Statistical analysis of the study was done using the Chi-square test. Results: Patients were 87.7% males and 12.3% females. The mean age was 40.3+/-10.8. Comorbidities were 20.2. The rates of use of substances were cigarettes 75.4%, alcohol 14.8% and other substances 15.7%. The rates of types of traumas were 14% Motor Vehicle Collisions, 6.1% Vehicles Striking Pedestrians, 3.5% Acts of Violence, 29.8% stabbing, 13.2% gunshot wounds, 33.4% falls. . Findings of thoracic injuries were 75.4% hemothorax, 72.8% pneumothorax, 61.4% contusion of the lungs, 49.1% fractures of the ribs, 18.4% subcutaneous emphysema, 9.6% cardiac injury, 5.2% diaphragmatic, 1.7% tracheobronchial and 0.8% esophageal injury. Surgically, which were 32.4% tube thoracostomy, 15.7% primary repair, and 10.5% thoracotomy among all traumas. The maximum length of stay in the Intensive-care Unit were for acts of violence and gunshot wounds and the maximum length of stay in the hospital were in acts of violence and falls from height. Conclusions: Thoracic traumas were more often in males. Penetrating injuries were more common in adults younger than 40 years and blunt traumas in adults older than 40 years. The majority of patients were without comorbidity. Surgically, these were done 100% parenchyma of the lung repair, 75% intercostal ligation, 41.6% thoracic wall reconstruction, 33.3% mediastinal surgery and 25% diaphragm repair in patients with thoracotomy. Rates of mortality were 13.3% in gunshot wounds and 2.9% in stabbing. Mortality rate was 2.6% in all thoracic traumas in the study.