Skip to main content

Advertisement

Log in

Factors related to clinical outcomes in blunt thoracic injuries

  • Original Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Objectives

This study aims to reduce mortality and morbidity by analyzing the factors associated with blunt chest trauma.

Methods

In this study, 1020 patients with blunt thoracic trauma were analyzed retrospectively. Major surgeries, complications, admission to intensive care unit, intubation, mortality, prolonged hospital stay were considered poor clinical outcomes. Independent variables were compared with clinical outcomes and analyzed.

Results

The mean age was 52.7 ± 19.1. Complications (p = 0.028) and mortality (p < 0.001) were higher in patients aged 65 years and older than those aged 65 years and younger. Severe chest wall injuries, hemopneumothorax, and pulmonary contusions were associated with poor clinical outcomes (OR = 2474, p = 0.001, OR = 2229, p < 0.001 and OR = 2229, p < 0.001, respectively). The variable most related to poor clinical outcomes was New Injury Severity Score (p < 0.001, OR = 8.37).

Conclusions

The most associated factor with poor clinical outcomes was injury severity. Prompt treatment of blunt chest trauma with timely chest tube thoracostomy or surgical treatment when necessary, optimal pain control, and chest physiotherapy will reduce mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Beshay M, Mertzlufft F, Kottkamp HW, Reymond M, Schmid RA, Branscheid D, et al. Analysis of risk factors in thoracic trauma patients with a comparison of a modern trauma centre: a mono-centre study. World J Emerg Surg. 2020;15:45.

    Article  Google Scholar 

  2. Perna V, Morera R. Prognostic factors in chest traumas: a prospective study of 500 patients. Cirugía Española (English Edition). 2010;87(3):165–70.

    Article  Google Scholar 

  3. World Health Organization. Men, ageing and health: achieving health across the life span (No. WHO/NMH/NPH/01.2). World Health Organization; 2001.

    Google Scholar 

  4. ASA House of Delegates. ASA physical status classification system. 2014. https://www.asahq.org/resources/clinical-information/asa-physical-status-classification-system

  5. Gennarelli TA. Abbreviated ınjury scale 1985 revision. American Association for Automotive Medicine; 1985.

    Google Scholar 

  6. Osler T, Baker SP, Long W. A modification of the injury severity score that both improves accuracy and simplifies scoring. J Trauma Acute Care Surg. 1997;43(6):922–6.

    Article  CAS  Google Scholar 

  7. Küçük MP, Küçük AO, Aksoy İ, Aydın D, Ülger F. Prognostic evaluation of cases with thoracic trauma admitted to the intensive care unit: 10-year clinical outcomes. Ulus Travma Acil Cerrahi Derg. 2019;25(1):46–54.

    PubMed  Google Scholar 

  8. Gupta AK, Sharma AK, Suthar NK, Girija HR, Verma V, Jindal SP. Epidemiological pattern of blunt trauma chest in Western India. Apollo Med. 2020;17(2):66.

    Article  Google Scholar 

  9. Demirhan R, Onan B, Oz K, Halezeroglu S. Comprehensive analysis of 4205 patients with chest trauma: a 10-year experience. Interact Cardiovasc Thorac Surg. 2009;9(3):450–3.

    Article  Google Scholar 

  10. Rapsang AG, Shyam DC. Scoring systems of severity in patients with multiple trauma. Cir Esp. 2015;93(4):213–21.

    Article  Google Scholar 

  11. Athanassiadi K, Theakos N, Kalantzi N, Gerazounis M. Prognostic factors in flail-chest patients. Eur J Cardiothorac Surg. 2010;38(4):466–71.

    Article  Google Scholar 

  12. Kostov K. Diagnosis and treatment of thoracic injuries and traumatic hemopneumothorax. J IMAB. 2021;27(1):3611–4.

    Article  Google Scholar 

  13. Chrysou K, Halat G, Hoksch B, Schmid RA, Kocher GJ. Lessons from a large trauma center: impact of blunt chest trauma in polytrauma patients—still a relevant problem? Scand J Trauma Resusc Emerg Med. 2017;25:42.

    Article  Google Scholar 

  14. Sirmali M, Türüt H, Topçu S, Gülhan E, Yazici U, Kaya S, Taştepe I. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg. 2003;24(1):133–8.

    Article  Google Scholar 

  15. Ludwig C, Koryllos A. Management of chest trauma. J Thorac Dis. 2017;9(Suppl 3):172.

    Article  Google Scholar 

  16. Emircan S, Ozgüç H, Akköse Aydın S, Ozdemir F, Köksal O, Bulut M. Factors affecting mortality in patients with thorax trauma. Ulus Travma Acil Cerrahi Derg. 2011;17(4):329–33.

    Article  Google Scholar 

  17. Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S. Chest injury due to blunt trauma. Eur J Cardiothorac Surg. 2003;23(3):374–8.

    Article  Google Scholar 

  18. Battle CE, Hutchings H, Evans PA. Risk factors that predict mortality in patients with blunt chest wall trauma: a systematic review and meta-analysis. Injury. 2012;43(1):8–17.

    Article  Google Scholar 

  19. Pape HC, Remmers D, Rice J, Ebisch M, Krettek C, Tscherne H. Appraisal of early evaluation of blunt chest trauma: development of a standardized scoring system for initial clinical decision making. J Trauma. 2000;49(3):496–504.

    Article  CAS  Google Scholar 

  20. Huber S, Biberthaler P, Delhey P, Trentzsch H, Winter H, van Griensven M, Trauma Register DGU, et al. Predictors of poor outcomes after significant chest trauma in multiply injured patients: a retrospective analysis from the German Trauma Registry (Trauma Register DGU®). Scand J Trauma Resusc Emerg Med. 2014;3(22):52.

    Article  Google Scholar 

  21. Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Matsuda H, Shimazaki S. Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma. 2002;52(4):727–32.

    PubMed  Google Scholar 

  22. Granetzny A, El-Aal MA, Emam E, Shalaby A, Boseila A. Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg. 2005;4(6):583–7.

    Article  Google Scholar 

  23. Marasco SF, Davies AR, Cooper J, Varma D, Bennett V, Nevill R, Lee G, Bailey M, Fitzgerald M. Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. J Am Coll Surg. 2013;216(5):924–32.

    Article  Google Scholar 

  24. Farquhar J, Almahrabi Y, Slobogean G, Slobogean B, Garraway N, Simons RK, et al. No benefit to surgical fixation of flail chest injuries compared with modern comprehensive management: results of a retrospective cohort study. Can J Surg. 2016;59(5):299.

    Article  Google Scholar 

  25. Wijffels MME, Hagenaars T, Latifi D, Van Lieshout EMM, Verhofstad MHJ. Early results after operatively versus non-operatively treated flail chest: a retrospective study focusing on outcome and complications. Eur J Trauma Emerg Surg. 2020;46(3):539–47.

    Article  Google Scholar 

  26. Fokin AA, Wycech J, Weisz R, Puente I. Outcome analysis of surgical stabilization of rib fractures in trauma patients. J Orthop Trauma. 2019;33(1):3–8.

    Article  Google Scholar 

  27. Kasotakis G, Hasenboehler EA, Streib EW, Patel N, Patel MB, Alarcon L, et al. Operative fixation of rib fractures after blunt trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2017;82(3):618–26.

    Article  Google Scholar 

  28. Bader A, Rahman U, Morris M, McCormack JE, Huang EC, Zawin M, et al. Pulmonary contusions in the elderly after blunt trauma: incidence and outcomes. J Surg Res. 2018;230:110–6.

    Article  Google Scholar 

  29. Lin FC, Tsai SC, Li RY, Chen HC, Tung YW, Chou MC. Factors associated with intensive care unit admission in patients with traumatic thoracic injury. J Int Med Res. 2013;41(4):1310–7.

    Article  Google Scholar 

Download references

Funding

There is no financial or material supporter for this study.

Author information

Authors and Affiliations

Authors

Contributions

There is no other contributor other than the author on the list.

Corresponding author

Correspondence to Mehmet Degirmenci.

Ethics declarations

Conflict of interest

The author (Mehmet Degirmenci) has no conflict of interest to declare.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Degirmenci, M. Factors related to clinical outcomes in blunt thoracic injuries. Gen Thorac Cardiovasc Surg 70, 804–811 (2022). https://doi.org/10.1007/s11748-022-01796-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-022-01796-5

Keywords

Navigation