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Thoracotomy in Thoracic Injuries: Results from a Tertiary Referral Hospital

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction:

Critically injured patients may require thoracotomy after a thoracic injury. This study is a retrospective analysis of the results of thoracotomy in patients with thoracic injury.

Materials and Methods:

Injured patients with detectable signs of life on arrival at the hospital and who underwent thoracotomy within 4 h of the injury were investigated. Demographic data and medical records were reviewed for associated injuries, indications, intraoperative findings, and outcomes. The factors affecting the mortality were analyzed.

Results:

Between April 2003 and January 2009, 488 patients with thoracic injury (blunt/penetrating = 73.7%/26.3%) were treated, and 20 (4.1%) underwent thoracotomy (male/female = 17/3, mean age = 27 ± 9 years). The injury was penetrating in 15 (11.7%) and blunt in five (1.4%). None of them required an endotracheal intubation at the scene or in transit. The mean transport time was 58 min. Severe and continuous hemothorax (80%), massive air leak, major vessel injury, and trauma causing an open chest wall defect with bleeding were indications of the thoracotomy. Eighty-five percent survived after the surgery (penetrating/ blunt = 86.6%/80%). The mean injury severity score (ISS) of the survivors was lower (21 ± 9 vs. 39 ± 10, p = 0.05). Mortality was associated with a lower Glasgow coma scale (GCS) (p = 0.03), a higher ISS (p = 0.05), and a longer transport time (p = 0.05).

Conclusions:

Thoracotomy after thoracic injury is a life-saving procedure in selected cases. Lower GCS and higher ISS are associated with increased mortality. Early transport and quick attempts to diagnose the indications necessitating thoracotomy play a significant role in improving the outcome.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Firat University Hospital, Firat University Faculty of Medicine, Elaziğ, Turkey

    Mehme Oğuzhan Özyurtkan, Akın Eraslan Balcı & Muharrem Çakmak

Authors
  1. Mehme Oğuzhan Özyurtkan
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  2. Akın Eraslan Balcı
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  3. Muharrem Çakmak
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Correspondence to Mehme Oğuzhan Özyurtkan.

Additional information

Presented at the 17th European Conference on General Thoracic Surgery, Krakow, Poland, 31 May–3 June 2009.

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Özyurtkan, M.O., Balcı, A.E. & Çakmak, M. Thoracotomy in Thoracic Injuries: Results from a Tertiary Referral Hospital. Eur J Trauma 36, 233–239 (2010). https://doi.org/10.1007/s00068-009-9149-2

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  • DOI: https://doi.org/10.1007/s00068-009-9149-2

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