Predicting Outcomes After Blunt Chest Trauma—Utility of Thoracic Trauma Severity Score, Cytokines (IL-1β, IL-6, IL-8, IL-10, and TNF-α), and Biomarkers (vWF and CC-16)

Background: Aim of this study was to validate thoracic trauma severity score (TTSS) in assessing the requirement of mechanical ventilation, mortality, and predicting prognosis in chest injury patients.Methods: This study was conducted in department of general surgery, Dr. S. N. Medical College, Jodhpur, Rajasthan, from December 2018 to September 2019. This was a single centred, prospective, observational study, conducted in 110 patients, aged >18 years, of isolated chest injury, excluding polytrauma patients. Data was summarized in the form of proportions, histograms and tables to show relationships of parameters with results. Data was presented as mean±SD and proportions as appropriate. Chi square test, z test or t tests were used wherever necessary for association analysis between categorical variables. Diagnostic test characteristics for mortality and complications was calculated from the ROC curves. A two sided of p values of less than 0.05 was considered statistically significant.Results: Most common mode of chest injury was blunt trauma and most common age group affected was 42-54 years. Maximum mortality was seen in TTSS between 16-20, shows higher the TTSS more the mortality. Ventilator requirement was more in high TTSS. Patients with higher TTSS had longer hospital stay as compared to patients with lower TTSS.Conclusions: On application of TTSS on admission, TTSS had direct correlation with need for oxygenation, ventilator need, duration of hospital stay, mortality or outcome in chest trauma patients. Thus we recommend TTSS as a good useful score for evaluation of prognosis, outcome and mortality in chest trauma patients.

Download Full-text

Primary Lung Hernia After Blunt Chest Trauma: Chest Wall Repair Strategies

The American Surgeon ◽

10.1177/00031348211023439 ◽

2021 ◽

pp. 000313482110234

Author(s):

Leonid A. Belyayev ◽

William J. Parker ◽

Emad S. Madha ◽

Elliot M. Jessie ◽

Matthew J. Bradley

Keyword(s):

Decision Making ◽

Chest Wall ◽

Surgical Management ◽

Blunt Chest Trauma ◽

Thoracic Trauma ◽

Chest Trauma ◽

Blunt Thoracic Trauma ◽

Lung Herniation ◽

Lung Hernia

Lung herniation is a rare pathology seen after trauma. A case of acquired lung hernia is presented after blunt thoracic trauma that was repaired primarily. Surgical management and decision-making for this process are discussed.

Download Full-text

Thoracic Trauma Severity score on admission allows to determine the risk of delayed ARDS in trauma patients with pulmonary contusion

Injury ◽

10.1016/j.injury.2015.08.031 ◽

2016 ◽

Vol 47 (1) ◽

pp. 147-153 ◽

Cited By ~ 44

Author(s):

Aurélien Daurat ◽

Ingrid Millet ◽

Jean-Paul Roustan ◽

Camille Maury ◽

Patrice Taourel ◽

...

Keyword(s):

Severity Score ◽

Thoracic Trauma ◽

Pulmonary Contusion ◽

Trauma Patients ◽

Trauma Severity

Download Full-text

Pneumoscrotum as Complication of Blunt Thoracic Trauma: A Case Report

Case Reports in Surgery ◽

10.1155/2013/392869 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Eftychios Lostoridis ◽

Konstantinos Gkagkalidis ◽

Nikolaos Varsamis ◽

Nikolaos Salveridis ◽

Georgios Karageorgiou ◽

...

Keyword(s):

Emergency Department ◽

Blunt Chest Trauma ◽

Thoracic Trauma ◽

Chest Trauma ◽

Vital Signs ◽

Rare Clinical Entity ◽

Blunt Thoracic Trauma ◽

Thoracic Cage ◽

Case Presentation ◽

The Right

Introduction. Pneumoscrotum is a rare clinical entity. It presents with swollen scrotal sac and sometimes with palpable crepitus. It has many etiologies. One of them is due to blunt trauma of the thoracic cage, causing pneumothorax and/or pneumomediastinum.Case Presentation. We report the case of an 82-year-old male who was transferred to the Emergency Department with signs of respiratory distress after a blunt chest trauma. A CT scan was obtained, and bilateral pneumothoraces with four broken ribs were disclosed. Subcutaneous emphysema expanding from the eyelids to the scrotum was observed, and a chest tube was inserted on the right side with immediate improvement of the vital signs of the patient.Discussion. Pneumoscrotum has three major etiologies: (a) local introduction of air or infection from gas-producing bacteria, (b) pneumoperitoneum, and (c) air accumulation from lungs, mediastinum, or retroperitoneum. These sources account for most of the cases described in the literature. Treatment should be individualized, and surgical consultation should be obtained in all cases.Conclusion. Although pneumoscrotum itself is a benign entity, the process by which air accumulates in the scrotum must be clarified, and treatment must target the primary cause.

Download Full-text

Management of thoracic trauma and analysis of risk factors in thoracic trauma patients

10.21203/rs.3.rs-18248/v1 ◽

2020 ◽

Author(s):

Morris Beshay ◽

Fritz Mertzlufft ◽

Hans Werner Kottkamp ◽

Thomas Vordemvenne ◽

Marc Reymond ◽

...

Keyword(s):

Risk Factors ◽

Injury Severity Score ◽

Severity Score ◽

Thoracic Trauma ◽

Chest Trauma ◽

Injury Severity ◽

Complication Rates ◽

Group I ◽

Group Ii ◽

Severe Lung

Abstract Objectives:Thoracic trauma (TT) is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. Its management is still a very challenging task. The purpose of this study was to analyse the epidemiological finding, risk factors affecting the outcome in a high volume trauma centre.Patients and methods:Between January 2003 and December 2012 data of all patients admitted to the Accident and Emergency (A&E) were prospectively collected at the German Trauma Registry (GTR) thereafter retrospectively analysed.Patients with chest trauma and Injury Severity Score (ISS) ≥18 and Abbreviated Injury Scale (AIS) >2 in more than one body region were included. Patients were divided into two groups; group I included patients with thoracic trauma between January 2003 to December 2007. The results of this group were compared with the results of other group (group II) in a later five years period (Jan. 2008-Dec. 2012). Univariate and multivariate analysis was done, Statistical difference with P<0.05 were considered significant.Results:There were 630 patients (56%) with thoracic trauma. 540 patients (48%) had associated extra thoracic injuries. Group I consisted of 285 patients (197 male, mean age 46 years). Group II consisted of 345 patients (251 male, mean age 49 year). Overall 90 days mortality was 17% (n=48) in group I vs. 9% (n=31) in group II (p=0.024). Complication rates were higher in group I (p=0.019). Higher injury severity score (ISS), and higher abbreviated injury score (AIS) thoracic showed higher rate of mortality (p<0.0001). Young patients (< 40 years) were frequently exposed to severe thoracic injury but showed less mortality rates (p=0.014). Patients with severe lung contusions (n=94) (15%) had higher morbidity and mortality (p<0.001). 23 (8%) Patients had emergency thoracotomy in group I vs. 14 patients (4%) in group II (p=0.041). Organ replacement procedures were needed in 18% in group I vs. 31% in group II (p=0.038).Conclusions:The presence of severe lung contusion, higher ISS and AISthoracic and advanced age are directly related to higher mortality rate. Instantly management of blunt chest trauma with corrected chest tube insertion, optimal pain control and chest physiotherapy resulted in good outcome in the majority of patients. Optimal management with better survival rates is achievable in specialized centre with a multidisciplinary teamwork and the presence of thoracic surgical experience.

Download Full-text

Frequency and importance of blush in lung contusion in patients with blunt trauma: A retrospective observational study

10.21203/rs.3.rs-168724/v1 ◽

2021 ◽

Author(s):

Naoki Tominaga ◽

Mineji Hayakawa ◽

Shoji Yokobori

Keyword(s):

Observational Study ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Injury Severity ◽

University Hospital ◽

Lung Contusion ◽

Retrospective Observational Study ◽

Splenic Trauma ◽

Trauma Severity ◽

Enhanced Computed Tomography

Abstract Background: The high mortality rate in patients with blunt chest trauma remains a problem. The assessment of blush in hepatic and splenic trauma is important because it indicates the need for emergency hemostatic intervention. However, the frequency and importance of blush in lung contusions are unknown. Therefore, this study aimed to evaluate the frequency of blush in the lung contusion and the relationship between blush and the clinical outcome of patients with blunt chest trauma.Methods: In this retrospective observational study, we enrolled patients with an injury severity score of 16 or higher and a chest abbreviated injury scale of 3 or higher who were admitted to the emergency department of Hokkaido University Hospital from January 1, 2003, to December 31, 2016. Blush was defined as an active extravasation image of an intravascular contrast agent recognized on contrast-enhanced computed tomography. Date of trauma severity, various treatments, and outcomes were recorded from the electrical medical records of the patients.Results: During the study period, 83 patients had severe lung contusions and 12 patients had blush. In-hospital mortality of patients with blush was significantly higher than that of patients without blush. Patients with blush required support through mechanical ventilation more frequently and for a longer duration than patients without blush.Conclusion: Our study revealed that blush in the lung contusions was not rare and was associated with a high risk of mortality in patients with severe blunt chest trauma. We should not hesitate to intervene if a blush of the lung contusion was detected in a patient with blunt chest trauma.

Download Full-text

Chest Radiography after Minor Chest Trauma

Acta Radiologica ◽

10.1177/028418518702800110 ◽

1987 ◽

Vol 28 (1) ◽

pp. 53-54 ◽

Cited By ~ 1

Author(s):

B. Rossen ◽

N. O. Laursen ◽

S. Just

Keyword(s):

Physical Examination ◽

Chest Radiography ◽

Blunt Chest Trauma ◽

Thoracic Trauma ◽

Chest Trauma

The results of chest radiography in 581 patients with blunt minor thoracic trauma were reviewed. Frontal and lateral views of the chest indicated pathology in 72 patients (12.4%). Pneumothorax was present in 16 patients; 4 had hemothorax. The physical examination and the results of chest radiography were not in accordance because in 6 (30%) of the 20 patients with hemo/-pneumothorax the physical examination was normal. Consequently there is wide indication for chest radiography after minor blunt chest trauma.

Download Full-text