Risk Factors Affecting the Prognosis in Patients with Pulmonary Contusion Following Chest Trauma
Introduction: Thoracic injury and its complications are responsible for as much as 25% for blunt trauma mortality. Pulmonary contusion occurs in 30%–75% of these cases. Despite advances in pulmonary care and intensive care management pulmonary contusion still contributes to higher mortality and...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2015-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/6375/13285_CE(RA1)_F(T)_PF1(VSUAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: Thoracic injury and its complications are responsible
for as much as 25% for blunt trauma mortality. Pulmonary contusion
occurs in 30%–75% of these cases. Despite advances in pulmonary
care and intensive care management pulmonary contusion still
contributes to higher mortality and morbidity for patients with severe
injuries.
Aim: To assess the outcome of pulmonary contusions in patients
with chest trauma and various factors determining mortality in
these patients.
Materials and Methods: A retrospective case study, over a period
of one year, of all chest trauma cases with pulmonary contusions
confirmed by X-rays or CT scan of thorax, were included in the
study. All the cases were assessed for age, associated injuries,
APACHE II score, SAPS II score, SOFA score, paO2
/Fio2
ratio,
fracture of ribs, presence of haemothorax or pneumothorax,
ventilator and ICU days and finally hospital outcome.
Results: A total of 16 cases of pulmonary contusions were
included in the study. Five patients died during the ICU stay and 11
survived. All patients had associated injuries. There was significant
difference seen in APACHE II score (p<0.001), SAPS II score
(p<0.001), SOFA score (p<0.001), paO2
/Fio2
ratio (p<0.022) and
ventilator days (p<0.001) among the survivors and non-survivors.
However, no significant difference was seen in presence of fracture
of ribs and presence of either haemothorax or pneumothorax.
Conclusion: The risk factors that were associated with higher
mortality in patients with pulmonary contusions following chest
trauma were APACHE II score, SAPS II score, SOFA score, paO2
/
Fio2
ratio and ventilator days. Close monitoring to improve the gas
exchange and better fluid management will help in improving the
survival in these patients. |
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| ISSN: | 2249-782X 0973-709X |