[The factors affecting the morbidity and mortality in chest trauma].

BACKGROUND

We evaluated thoracic trauma cases with respect to etiologic causes, other system injuries accompanying to the thoracic trauma, treatment methods and outcomes and the prognostic factors affecting the need for thoracotomy, length of hospital stay, morbidity and mortality in the light of relevant literature data.

METHODS

A retrospective evaluation was performed on 141 patients (102 males (72.3%), 39 females (27.7%); mean age 40; range 8 to 89 years) who were treated for thoracic trauma in our center between July 2003 and December 2005.

RESULTS

117 patients (83%) had blunt and 24 (17%) penetrating thoracic trauma. Isolated thoracic trauma and multisystem trauma were found in 48 (34%) and 93 (66%) patients, respectively. Mean white blood cell count was 12.560+/-5.7 (5-25 x 103 /uL) at admission. The number of patients who met lung injury scale criteria for grade I, grade II, grade III and grade IV were 19 (13.5%), 12 (8.5%), 25 (17.7%) and 13 (9.2%), respectively. Hypotension was determined in 16 patients (11.3%) during admission. With regard to treatment, while symptomatic conservative management was satisfactory in 76 patients (53.9%), tube thoracoscopy and thoracotomy were performed in 59 (41.8%) and 11 (7.8%) patients respectively. The morbidity was seen in 30 patients (21.3%). The mortality rate was 7.8% (n=11).

CONCLUSION

The high white blood cell count, high lung injury scale grade, 3 and more rib fractures and accompanying head injury were determined as the prognostic factors affecting the morbidity and mortality.