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...

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Main Authors: Chaudhury Alisha, Gaude Gajanan, Hattiholi Jyothi
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2015-08-01
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
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author Chaudhury Alisha
Gaude Gajanan
Hattiholi Jyothi
author_facet Chaudhury Alisha
Gaude Gajanan
Hattiholi Jyothi
author_sort Chaudhury Alisha
collection DOAJ
description 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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spelling doaj.art-468a1a15810142f8899fc4d5525da8382022-12-22T01:07:22ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2015-08-0198OC17OC1910.7860/JCDR/2015/13285.6375Risk Factors Affecting the Prognosis in Patients with Pulmonary Contusion Following Chest TraumaChaudhury Alisha0Gaude Gajanan1Hattiholi Jyothi2Senior Resident, Department of Pulmonary Medicine, KLE University’s J. N. Medical College, Belgaum, India.Professor and Head, Department of Pulmonary Medicine, KLE University’s J. N. Medical College, Belgaum, India.Assistant Professor, Department of Pulmonary Medicine, KLE University’s J. N. Medical College, Belgaum, India.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.https://jcdr.net/articles/PDF/6375/13285_CE(RA1)_F(T)_PF1(VSUAK)_PFA(AK)_PF2(PAG).pdfblunt chest injurymortalityprognosisrib fractures
spellingShingle Chaudhury Alisha
Gaude Gajanan
Hattiholi Jyothi
Risk Factors Affecting the Prognosis in Patients with Pulmonary Contusion Following Chest Trauma
Journal of Clinical and Diagnostic Research
blunt chest injury
mortality
prognosis
rib fractures
title Risk Factors Affecting the Prognosis in Patients with Pulmonary Contusion Following Chest Trauma
title_full Risk Factors Affecting the Prognosis in Patients with Pulmonary Contusion Following Chest Trauma
title_fullStr Risk Factors Affecting the Prognosis in Patients with Pulmonary Contusion Following Chest Trauma
title_full_unstemmed Risk Factors Affecting the Prognosis in Patients with Pulmonary Contusion Following Chest Trauma
title_short Risk Factors Affecting the Prognosis in Patients with Pulmonary Contusion Following Chest Trauma
title_sort risk factors affecting the prognosis in patients with pulmonary contusion following chest trauma
topic blunt chest injury
mortality
prognosis
rib fractures
url https://jcdr.net/articles/PDF/6375/13285_CE(RA1)_F(T)_PF1(VSUAK)_PFA(AK)_PF2(PAG).pdf
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