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Eur J Cardiothorac Surg 2003;23:374-378
© 2003 Elsevier Science NL
General Thoracic Surgery Department, Atatürk Center for Chest Diseases and Thoracic Surgery, Ankara, Turkey
Received 18 August 2002; received in revised form 28 November 2002; accepted 3 December 2002.
* Corresponding author. 2619.sok Akemek sitesi C1, Blok Daire no. 6, Çamlik, Denizli 20020, Turkey. Tel.: +90-258-241-0034; fax:: +90-258-241-0040
e-mail: tubaliman{at}yahoo.com
Objective: Given its importance in trauma practice, we aimed to determine the pathologies associated with blunt chest injuries and to analyze the accurate identification of patients at high risk for major chest trauma. Methods: We reviewed our experience with 1490 patients with blunt chest injuries who were admitted over a 2-year period. Patients were divided into three groups based on the presence of rib fractures. The groups were evaluated to demonstrate the relationship between the number of rib fractures and associated injuries. The possible effects of age and Injury Severity Score (ISS) on mortality were analyzed. Results: Mean hospitalization time was 4.5 days. Mortality rate was 1% for the patients with blunt chest trauma, 4.7% in patients with more than two rib fractures and 17% for those with flail chest. There was significant association between the mortality rate and number of rib fractures, the patient's age and ISS. The rate of development of pneumothorax and/or hemothorax was 6.7% in patients with no rib fracture, 24.9% in patients with one or two rib fractures and 81.4% in patients with more than two rib fractures. The number of rib fractures was significantly related with the presence of hemothorax or pneumothorax. Conclusion: Achieving better results in the treatment of patients with chest wall injury depend on a variety of factors. The risk of mortality was associated with the presence of more than two rib fractures, with patients over the age of 60 years and with an ISS greater than or equal to 16 in chest trauma. Those patients at high risk for morbidity and mortality and the suitable approach methods for them should be acknowledged.
Key Words: Blunt trauma • Chest injury • Rib fracture
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