The penetrating thoracic trauma in the emergency department: Retrospective analysis of 76 patients

Öz

The penetrating thoracic trauma in the emergency department: Retrospective analysis of 76 patients Objective: Trauma is the most frequent cause of death among the young population. Thoracic trauma is responsible for 25% of all deaths due to trauma, and contributes to mortality among the other 25% of deaths due to trauma. In this study, analysis of 76 patients admitted to the emergency department with penetrating chest trauma was performed. Materials and Methods: 76 patients admitted to the emergency department with penetrating chest trauma in 2010 were included to the study. Age, gender, causes of trauma, admission times, thoracic pathologies, diagnostic methods and their results, medical managements, hospitalization information and concomitant injuries were analyzed. 76 patients were included in the study. The mean age was 31.4 , 93.4% of patients were male (n=71), F/M ratio was 14.2. Results: The most common cause of penetrating trauma was stab injury (59 patients, 77.6%), the second most common cause was gunshot injury (14 patients, 18.4%). The most common pathology associated with chest trauma were extremity injury (19 people, 24%). 24 patients (31.5%) were followed conservatively; tube thoracostomy were performed to 40 (52.6%) of the patients. Conclusions: The most frequent cause of penetrating chest trauma is stab injury, it can be treated frequently with conservative management and tube thoracostomy

Anahtar Kelimeler

• penetrating thoracic trauma
• hemothorax
• pneumothorax
• emergency medicine

Acil serviste penetran göğüs travması: 76 vakanın analizi

Öz

Özet Amaç: Travma, genç nüfusun başta gelen ölüm nedenidir. Bütün travmaya bağlı ölümlerin %25'den toraks travması sorumludur ve diğer %25'de mortaliteye katkı sağlamaktadır. Bu çalışmada acil servise penetran göğüs travması ile başvuran hastaların analizi yapılmıştır. Gereç ve Yöntem: 2010 yılı içerisinde acil servise başvuran 76 penetran göğüs travmalı hastanın yaş, cinsiyet, travma tipi, torasik ve ekstratorasik patoloji, travma sonrası geçen süre, uygulanan medikal tedavi, mortalite yönünden analiz edildi. Bulgular: Çalışmaya 76 hasta çalışmaya dahil edildi. Yaş ortalaması 31.4 idi (18-63 arası) ve %93.4'ü erkekti (n:71). Penetran göğüs travmasının en sık delici-kesici alet yaralanması ile gerçekleşmiştir (59 hasta, %77.63), 14 hasta (%18.42) ise ateşli silah yaralanmasına maruz kalmıştır. Göğüs travmasına en sık eşlik eden patoloji 19 kişi (%24) ile ekstremite yaralanması idi. Hastaların 24'ü (%31.5) konservatif olarak izlenmiştir; 40 (%52.6) hastaya göğüs tüpü uygulanmıştır. Sonuç: Penetran göğüs travmaları çoğunlukla konservatif yöntemlerle ve tüp torakostomi ile tedavi edilebilir. Yelken göğüs gibi ağır patolojilerde mekanik ventilatör desteği ve yoğun bakım tedavisi gerekebilir. Anahtar Kelimeler: penetran toraks travması, hemotoraks, pnömotoraks, acil servis

Anahtar Kelimeler

• penetran toraks travmasý
• hemotoraks
• pnömotoraks
• acil servis

Kaynakça

1. LoCicero J, 3rd, Mattox KL. Epidemiology of chest trauma. Surg Clin North Am. 1989 Feb;69(1):15-9.
2. Özçelik C, Balcý AE, Eren Þ, Ülkü R, Doblan M, Eren N. Toraks travmalarý (10 yýllýk deneyim). Ulusal Travma Dergisi. 2000;6:44-9.
3. VanNata TL, Morris JA. Injury scoring and trauma ourcomes. In: Mattox KL, Feliciano DV, Moore EE, editors. Trauma. New York: NY:McGraw Hill Companies; 2000. p. 69-80.
4. Hoyert DL, Heron MP, Murphy SL, Kung HC. Deaths: final data for 2003. Natl Vital Stat Rep. 2006 Apr 19;54(13):1-120.
5. Trupka A, Waydhas C, Hallfeldt KK, Nast-Kolb D, Pfeifer KJ, Schweiberer L. Value of thoracic computed tomography in the first assessment of severely injured patients with blunt chest trauma: results of a prospective study. J Trauma. 1997 Sep;43(3):405-11; discussion 11-2.
6. Robison PD, Harman PK, Trinkle JK, Grover FL. Management of penetrating lung injuries in civilian practice. J Thorac Cardiovasc Surg. 1988 Feb;95(2):184-90.
7. Tekinbas C, Eroglu A, Kurkcuoglu IC, Turkyilmaz A, Yekeler E, Karaoglanoglu N. [Chest trauma: analysis of 592 cases]. Ulus Travma Acil Cerrahi Derg. 2003 Oct;9(4):275-80.
8. Guitron G, Huffman LC. Blunt and penetrating injuries of the chest wall, pleura, and lungs. In: Shields TW, editor. General Thoracic Surgery. Fifth ed. Philadelphia: Williams and Wilkins; 2009. p. 891-903.

9. Reed RL. Lung Infections and Trauma. In: Norton JA, Bollinger RR, Chang AE, Lowry SF, Mulvihill SJ, Pass HI, Thompson RW, eds. Surgery: Basic Science and Clinical Evidence. New York, NY: Springer-Verlag; 2001:1217-30.
10. Soysal Ö. Künt göðüs travmalarý. In: Yüksel M, Göksel NG, editors. Göðüs cerrahisi. 1st ed. Ýstanbul: Bilmedya Grup; 2011. p. 447-64.
11. Rubikas R. Diaphragmatic injuries. Eur J Cardiothorac Surg. 2001 Jul;20(1):53-7.
12. Rosati C. Acute traumatic injury of the diaphragm. Chest Surg Clin N Am. 1998 May;8(2):371-9.
13. Shah R, Sabanathan S, Mearns AJ, Choudhury AK. Traumatic rupture of diaphragm. Ann Thorac Surg. 1995 Nov;60(5):1444-9.
14. Reber PU, Schmied B, Seiler CA, Baer HU, Patel AG, Buchler MW. Missed diaphragmatic injuries and their long-term sequelae. J Trauma. 1998 Jan;44(1):183-8.