Prognostic factors in chest traumas: A prospective study of 500 patients

Información del artículo

Abstract

Objective

Identify the factors of greatest impact in patients with chest trauma.

Patients and methods

A prospective study of 500 patients (425 men and 75 women) with chest trauma treated between January 2006 and December 2008. The parameters assessed include the degree of trauma, the abbreviated injury scale (AIS), the injury severity score (ISS), prehospital intubation, duration of mechanical ventilation, length of stay in the intensive care unit (ICU), number of rib fractures, presence of pulmonary contusion, haemothorax and cardio-pulmonary effects.

Results

The presence of polytrauma, the number of rib fractures, the presence of flail chest, pulmonary contusion, the delay in mechanical ventilation and age were shown to be effective markers of severity.

Conclusions

Thoracic injuries have a number of markers of severity. The mortality risk is associated with an ISS >25, the presence of 3 or more rib fractures with flail chest, pulmonary contusion, the development of ARDS, and with age >55.

Keywords:

Chest injuries

Blunt trauma

Rib fracture

Polytrauma

Resumen

Objetivo

Identificar los factores pronóstico de mayor impacto en el paciente con traumatismo torácico.

Método

Estudio prospectivo de 500 pacientes (425 hombres y 75 mujeres) con traumatismo torácico atendidos entre enero de 2006 y diciembre de 2008. Los parámetros valorados incluyen el grado del traumatismo, la abbreviate injury scale, el injury severity score, la intubación prehospitalaria, la duración de la ventilación mecánica, la estancia en unidad de cuidados intensivos, el número de fracturas costales, la presencia de contusión pulmonar, hemotórax y repercusión cardiopulmonar.

Resultados

La presencia de politraumatismo, el número de fracturas costales, la presencia de volet, la contusión pulmonar, el retraso en la ventilación mecánica y la edad se han demostrado marcadores eficaces de gravedad.

Conclusiones

Los traumatismos torácicos tienen una serie de indicadores de gravedad: el riesgo de mortalidad se asocia con un injury severity score > 25, la presencia de 3 o más fracturas costales con volet costal, contusión pulmonar, el desarrollo de ARDS y con una edad > 55 años.

Palabras clave:

Traumatismos torácicos

Traumatismo cerrado

Fractura costal

Politrauma

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