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Thoracic and Abdominal Injuries

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Anesthesia for Trauma

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Abstract

Injuries to the thorax and the abdomen—the torso—contribute significantly to trauma-related mortality and morbidity. While the vulnerability of the closely organized vital organs to injury in this region plays an important role in morbidity and mortality, the noncompressible nature of hemorrhage in this area also contributes immensely to otherwise preventable trauma deaths. While it is estimated that one fourth of trauma deaths is secondary to chest trauma alone and claims about 16,000 lives per year [1], hemorrhage in the torso (thorax, abdomen, and pelvis) also results in a mortality of as much as 70–80 % after otherwise survivable noncerebral and noncardiac injuries in both civilian and military populations [2]. The overall mortality from exsanguination, which remains second to central nervous system (CNS) injury as a cause of death, primarily originates from injuries of the thorax, abdomen, and pelvis; there has been a reduction in death from extremity bleeding because of effective control with tourniquets or topical hemostatic agents, but not from torso bleeding. With increasing use of anticoagulant agents for prophylaxis and management of cardio- and cerebrovascular disorders, bleeding-related mortality from truncal injuries is probably more frequent. For example, the predominant injury site in patients with cardiovascular disease who died after trauma in one study was chest in 15 % and abdomen in 3 % of instances; head and neck was the injury site in 69 % of patients [3].

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  1. NYU Medical Center and Bellevue Hospital Center, 550 First Avenue, New York, NY, 10016, USA

    Levon M. Capan M.D. & Sanford M. Miller M.D.

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  2. Sanford M. Miller M.D.
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Correspondence to Levon M. Capan M.D. .

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  1. Bellevue Hospital Center, New York University, New York, New York, USA

    Corey S. Scher

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Capan, L.M., Miller, S.M. (2014). Thoracic and Abdominal Injuries. In: Scher, C. (eds) Anesthesia for Trauma. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0909-4_11

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