Overview of thoracic trauma in the United States.

Most patients with injuries to the chest (approximately 75%) can usually be managed expectantly with simple tube thoracostomy and volume resuscitation [1,11,21-24]. As a result, initial care of these patients is usually straightforward and often performed adequately by emergency room physicians and general surgeons. Tertiary care of these patients is often multidisciplinary in nature, however, and communication with the thoracic surgeon is essential to minimize mortality and long-term morbidity. Improvement in the understanding of the underlying molecular physiologic mechanisms involved in the various traumatic pathologic processes, and the advancement of diagnostic techniques, minimally invasive approaches, and pharmacologic therapy, all continue to contribute to decreasing the morbidity and mortality of these critically injured patients.