Thoracic trauma. One year experience at the Hospital Civil Fray Antonio Alcalde

Carlos Alberto Jiménez Fernández; Sulei Bautista González; Oscar Ramón Guzmán Chávez; Javier Soto Vargas; Nohemi Preciado Amador; Rodrigo Rostro Rivera; Jaime Gilberto Lopez Taylor; Francisco Guadalupe Sandoval Vírgen.

2012, Number 4

Rev Med MD 2012; 3.4 (4)

Thoracic trauma. One year experience at the Hospital Civil Fray Antonio Alcalde

Jiménez-Fernández CA, Bautista-González S, Guzmán-Chávez OR, Soto-Vargas J, Preciado-Amador N, Rostro-Rivera R, Lopez-Taylor JG, Sandoval-Virgen FG

Full text

How to cite this article

Language: Spanish
References: 18
Page: 186-190
PDF size: 523.20 Kb.

ABSTRACT

Background: Thorax lesions represent a quarter of traumatic lesions and cause the 50% of deaths by trauma. They constitute the sixth cause of mortality in our country. They are more frequent in males in economically active age. Objective: To analyze the experience in thorax traumatism in the service of Cardiothoracic surgery at the Hospital Civil Fray Antonio Alcalde.
Methods: Transversal and descriptive study. All the patients with thoracic traumatism admitted in the service of Cardiothoracic surgery at the Fray Antonio Alcalde Civil Hospital during the period covering the January 1st, 2010 to December 31st, 2010. The variables analyzed were age, sex, thoracic lesion features and related, admittance to the intensive therapy unit, gravity of the lesion, radiographic findings, treatment, time between lesion and admittance, patient’s evolution, days of in-hospital stay, morbidity and mortality.
Results: From 251 patients, 86.45% correspond to male gender and 13.55% to female gender. The mean age was 38.1±11.88. The type of traumatism was blunt in 35.86% and penetrating in 55.38%. The most frequent complication was atelectasis in 4.8% of the cases. 75% of the cases required pleural tube collocation water seal system, thoracotomy in 7.17% and preservative handling in 20.7%. Mortality was 6.32%. The only factor associated to mortality was abdominal lesion (p‹0.001, OR 10.2 IC95% 2.80-37.12).
Conclusions: The thoracic trauma represents the most important cause of admittance to the emergency service. Most are resolved with the collocation of pleural drainage. The presence of abdominal lesion is associated significantly to great mortality.

REFERENCES

1.Secretaría de Salud. Dirección General de Estadística e Informática. Mortalidad. México; SS; 2007
2.Marcia Valenzuela D, Patricio Cancino A, Francisco Cabezas S, Gisela Donoso D, Ignacio de la Torre. Experiencia en traumatismo torácico. Hospital Valparaíso. Rev. Chilena de Cirugía. Vol. 55 – No 5 Octubre 2003. Pp 4449-453.
3.Johnny Méndez Acuña. Incidencia de Cirugía Torácica Servicio de Cirugia Hospital Santa Bárbara. Revista Instituto Medico Sucre LXV: 117(54-57) 2000.
4.F. Guzmán, J.C. Ramírez, Ramírez, G. Rodríguez, G. Supelano M. Cadena J. Escallon F. Holguín, Richens. Trauma de Tórax. Revista Colombiana de Cirugía. 1990 Vol. 5 No 1 pp 38-45.
5.American College of Surgeons Commitee on Trauma: Advanced Trauma Life Support.
6.Riyad Karmy-Jones, Avery Nathens, Gregory J. Jurkovich, David V. Shatz, Susan Brundage, Mathew J. Wall, Jr., Sandra Engelhardt, David B. Hoyt, John Holcroft, M. Margaret Knudson, Andrew Michaels, and William Long, M. Urgent and Emergent Thoracotomy for Penetrating Chest Trauma. The Journal of TRAUMA Injury, Infection, and Critical Care. 2004;56:664 –669.
7.Asensio JA, O'Shanahan G, Petrone P, Costa D, Robin-Lersundi A. Emergency thoracotomy: a critical evaluation of the technique. Cir Gen 2004;26:128-37.
8.Cothren C, Moore EE. Emergency department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. World J Emerg Surg. 2006; 1: 4.
9.Morales Wong Mario MigueL, Gómez Hernández Mario Michel, Ramos Godines Alexander, González Folch Rolando. Lesiones torácicas graves y el enfoque del control de daños. Rev Cubana Cir 2008; 47(1)
10.www.fepafem.org.ve/Guias_de_Urgencias/Trauma/Trauma_pulmonar.pdf
11.Maylen Llerena Rodríguez ET AL, Caracterización de la evaluación del traumatismo torácico. Rev Cub Med Int Emerg 2007;6(4):896-910
12.Hans-Christoph Pape, Dierk Remmers, John Rice, Marc Ebisch, , Christian Krettek, and Harald Tscherne. Appraisal of Early Evaluation of Blunt Chest Trauma: Development of a Standardized Scoring System for InitialClinical Decision Making. The Journal of Trauma Injury, Infection, and Critical Care. 2000;49:496 –504.
13.Tte. Cor Tomás Ariel Lombardo Vaillant. Manejo de los seis grandes del trauma torácico. Primera parte. Rev Cub Med Mil v.37 n.1 Ciudad de la Habana ene.-mar. 2008
14.Martinus Richter, Christian Krettek, Dietmar Otte, BSC, B. Wiese, MichaeL Stalp, Stefan Ernst, and Hans-Cristoph Pape. Correlation between Crash Severity, Injury Severity, and Clinical Course in Car Occupants with Thoracic Trauma: A Technical and Medical Study. The Journal of Trauma Injury, Infection, and Critical Care. 2001; 50:10 –16.
15.Copes WS, Champion HR, Sacco W.J. Lawnick MM, Keast SL, Bain LW. The Injury Severity Score Revisited. Journal of Trauma 1988;28:69-77.
16.Champion, Howard R; Copes, Wayne S. Sacco, William J. Lawnick, Mary M. .; Bain, Larry W.; Gann, Donald S. Gennarelli, Thomas; Mackenzie, Ellen; Schwaitzberg, Steven . A New Characterization of Injury Severity. Journal of Trauma-Injury Infection & Critical Care. 30(5):539-546, May 1990.
17.Baker SP, O'Neill B, Haddon W JR, Long WB. The Injury Severity Score: a method for describing patients with multiple injuries and evaluating emergency care. Journal Trauma 1974;14:187-96.
18.José Juan Agúndez Meza, Francisco Cardoza Macías. Comparación de ISS (Escala de severidad de lesiones) con resultado final del tratamiento. Cirujano General, Volumen 22, Núm. 1 Enero-Marzo 2000 pp. 9-17.