The double jeopardy of blunt thoracoabdominal trauma

Archives of Surgery
Regan J BergD Demetriades

Abstract

To examine the specific injuries, need for operative intervention, and clinical outcomes of patients with blunt thoracoabdominal trauma. Trauma registry and medical record review. Level I trauma center in Los Angeles, California. All patients with thoracoabdominal injuries from January 1996 to December 2010. Injuries, incidence and type of operative intervention, clinical outcomes, and risk factors for mortality. Blunt thoracoabdominal injury occurred in 1661 patients. Overall, 474 (28.5%) required laparotomy, 31 (1.9%) required thoracotomy (excluding resuscitative thoracotomy), and 1146 (69.0%) required no thoracic or abdominal operation. Overall incidence of intraabdominal solid organ injury was 59.7% and hollow viscus injury, 6.0%. Blunt cardiac trauma occurred in 6.3%; major thoracic vessel injury, in 4.6%; and diaphragmatic trauma, in 6.0%. The majority of solid organ injuries were managed nonoperatively (liver, 83.9%; spleen, 68.3%; and kidney, 91.2%). Excluding patients with severe head trauma, mortality ranged from 4.5% with nonoperative management to 18.1% and 66.7% in those requiring laparotomy and dual cavitary exploration, respectively. Age 55 years or older, Injury Severity Score of 25 or more, Glasgow Coma Scale s...Continue Reading

Citations

Jan 1, 2013·Interactive Cardiovascular and Thoracic Surgery·Maziar KhorsandiRajesh Shah
May 1, 2015·Science Translational Medicine·David BrownYoram Vodovotz
Oct 31, 2015·Revista do Colégio Brasileiro de Cirurgiões·Silvania Klug PimentelIwan Augusto Collaço
Dec 11, 2014·The Journal of Trauma and Acute Care Surgery·Regan J BergDemetrios Demetriades
Jul 17, 2018·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Edward John NevinsNikhil Misra
Sep 29, 2019·International Journal of Environmental Research and Public Health·Wei-Ti SuChing-Hua Hsieh
Feb 5, 2021·Frontiers in Immunology·Lukas SchimunekYoram Vodovotz
Nov 6, 2020·Annals of Medicine and Surgery·Chunlaches ChaijareenontNapaphat Poprom
May 8, 2021·Scientific Reports·Nabil AzharYoram Vodovotz

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