Black T L, Snyder C L, Miller J P, Mann C M, Copetas A C, Ellis D G
Department of Pediatric Surgery, Cook-Fort Worth Children's Medical Center, Tex., USA.
South Med J. 1996 May;89(5):494-6. doi: 10.1097/00007611-199605000-00009.
Chest trauma in children is a marker of injury severity and is associated with a high mortality rate. This retrospective study of 1,356 trauma patients from a private pediatric hospital over a 2.5-year period identified 82 patients with chest injuries and a mortality rate of 22%. Results of Injury Severity Score, Glasgow Coma Scale, and Revised Trauma Score all indicated that children with chest injuries sustained more severe injuries. The presence of any extrathoracic injury was associated with a higher mortality (29%) than chest injury alone (4.3%). The type of extrathoracic injury was important, with head and neck injuries resulting in the highest mortality. Specific chest injuries, such as rib fractures and pulmonary contusions, were not related to increased mortality unless there was an associated extrathoracic injury. Many reports have shown a high mortality associated with chest trauma. This study suggests that it is the associated extrathoracic injury, rather than the chest injury itself, that is the real cause of the high mortality.
儿童胸部创伤是损伤严重程度的一个指标，且与高死亡率相关。这项对一家私立儿童医院2.5年期间的1356例创伤患者进行的回顾性研究，确定了82例胸部损伤患者，死亡率为22%。损伤严重程度评分、格拉斯哥昏迷量表和修订创伤评分的结果均表明，胸部损伤的儿童遭受了更严重的损伤。任何胸外损伤的存在都比单纯胸部损伤（4.3%）有更高的死亡率（29%）。胸外损伤的类型很重要，头部和颈部损伤导致的死亡率最高。特定的胸部损伤，如肋骨骨折和肺挫伤，除非伴有胸外损伤，否则与死亡率增加无关。许多报告显示胸部创伤与高死亡率相关。这项研究表明，导致高死亡率的真正原因是相关的胸外损伤，而非胸部损伤本身。
