Thoracic trauma: an analysis of 521 patients

Abstract

BACKGROUND: We evaluated thoracic trauma cases with regard to etiologic causes, treatment methods, outcome, and factors affecting the results in the light of our experience and relevant literature data. METHODS: A retrospective evaluation was made of 521 patients (399 males, 122 females; mean age 42 years; range 4 to 93 years) who were treated for thoracic trauma from September 1997 to August 2002. RESULTS: Isolated thoracic trauma and multisystem trauma were found in 348 (67%) and 173 (33%) patients, respectively. Blunt injuries accounted for 87%, the most common cause being traffic accidents (62%), and penetrating injuries accounted for 13%. The most frequent thoracic pathologies included multiple (56%) and single (24%) rib fractures, and flail chest (8.4%). Extrathoracic injuries were seen in 33.2%, the extremities (41%) and the skull (40%) being the most commonly involved. Treatment consisted of symptomatic treatment in 159 patients (30.5%), tube thoracostomy in 337 patients (64.6%), and thoracotomy in 15 patients (2.9%). In isolated thoracic trauma and multisystem trauma, morbidity rates were 3.4% and 22%, and mortality rates were 2.5% and 16.2%, respectively. The overall mortality was 7.1% (37 patients). The mean length of hospital stay was 7.1 days (range 1 to 64 days). CONCLUSION: A great majority of thoracic trauma patients can be treated with conservative methods or tube thoracostomy. Accompanying multisystem traumas are associated with dramatic increases in morbidity and mortality rates.