Pasquali Gabrielle Filinkoski, Kock Kelser de Souza
University of Southern Santa Catarina (UNISUL), Medicine Course Tubarão, Santa Catarina, Brazil.
Int J Burns Trauma. 2021 Feb 15;11(1):54-61. eCollection 2021.
Thoracic trauma is one of the most common types, corresponding to 10% of the traumas admitted in emergency services.
To analyse epidemiologic aspects of patients diagnosed with chest trauma in a hospital at the south of Brazil and its predictive factor for prolonged length of stay.
We conducted a retrospective cohort involving patients who were victims of chest trauma. They were described by the International Classification of Diseases (ICD) from S20 to S29 admited in a regional hospital in Southern Brazil, from January 2008 to December 2018. The analysed variables were: sex, age, ICD, type of trauma, complication, need for intensive care unit (ICU), mechanical ventilation (MV) and oxygen therapy (O), scores on Injury Severity Score (ISS) and Thoracic Trauma Severity Score (TTSS) and outcomes length of stay and death.
121 patients were evaluated, with median age 47.0 (35-0-58.5) years, where 84.3% being of them were male. Blunt trauma had a higher prevalence with 85.1%, with the most frequent complication being spine fractures (30.4%), followed by rib fractures (23.2%) and pneumothorax (16.8%). There was need of ICU in 14%, use of O in 30.6% and need of MV in 5.8%. The median length of stay was 6.0 (4.0-10.5), and death as an outcome was found in only 1.7%. Relying on the TTSS, the median (p25-p75) found was 3.0 (2.0-5.0) points and the ISS score was 4.0 (0.0-9.0). If observing patients with a length of stay ≥ 6 days, there were an association with the female gender, need of ICU, O and MV, ISS scores, and TTSS scores in the categories who involved pleural commitment and minor PaO/FiO.
Most of the victims were male young adults with low mortality. The TTSS and ISS were found to be adequate predictors of prolonged length of stay.
胸部创伤是最常见的创伤类型之一，占急诊收治创伤病例的10%。
分析巴西南部一家医院确诊的胸部创伤患者的流行病学特征及其住院时间延长的预测因素。
我们进行了一项回顾性队列研究，纳入胸部创伤患者。这些患者根据国际疾病分类（ICD）从S20至S29进行分类，于2008年1月至2018年12月在巴西南部一家地区医院入院。分析的变量包括：性别、年龄、ICD、创伤类型、并发症、是否需要重症监护病房（ICU）、机械通气（MV）和氧疗（O）；损伤严重程度评分（ISS）和胸部创伤严重程度评分（TTSS）；住院时间和死亡结局。
共评估了121例患者，中位年龄为47.0（35.0 - 58.5）岁，其中84.3%为男性。钝性创伤的患病率较高，为占85.1%，最常见的并发症是脊柱骨折（30.4%），其次是肋骨骨折（23.2%）和气胸（16.8%）。14%的患者需要入住ICU，30.6%的患者需要氧疗，5.8%的患者需要机械通气。中位住院时间为6.0（4.0 - 10.）天，死亡结局仅占1.7%。根据TTSS，中位（第25 - 75百分位数）评分为3.0（2.0 - 5.0）分，ISS评分为4.0（0.0 - 9.0）分。如果观察住院时间≥6天的患者，发现其与女性性别、需要ICU、氧疗和机械通气、ISS评分以及涉及胸膜受累和低动脉血氧分压/吸入氧分数值（PaO/FiO）类别的TTSS评分相关。
大多数受害者为年轻男性，死亡率较低。发现TTSS和ISS是住院时间延长的充分预测指标。
