The American surgeon · 2020
Delayed Respiratory Failure After Blunt Chest Trauma.
СтатьяНазвание и аннотация: Перевод в очереди
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Martin Christina S, Lu Ning, Inouye David S, Nakagawa Kazuma, Ng Karen, Yu Mihae, Hayashi Michael S
Аннотация
BACKGROUND: Patient factors associated with delayed respiratory failure (DRF) after blunt chest trauma are not well documented. Earlier identification and closer monitoring may improve outcomes for these patients. The purpose of this study was to identify the prevalence and clinical predictors of DRF in patients after blunt chest trauma.
MATERIALS AND METHODS: A retrospective review of adult patients admitted to a Level 1 trauma center after blunt chest trauma between January 1, 2009 and December 31, 2013, was conducted. Patients with early respiratory failure were compared to patients with DRF using Fisher's exact tests, chi square, and Student's t-tests. A P-value of <.05 was considered significant.
RESULTS: 1299 patients had blunt chest trauma and at least 1 rib fracture, of which 830 met inclusion criteria. 5.8% of patients progressed to respiratory failure. Respiratory failure was delayed in 25% of these patients. DRF patients had significantly lower ISS (16.5 vs. 22.7, P = .04), more bilateral rib fractures (66.7% vs. 28.7%, P = .02) and fewer pulmonary contusions (16.7% vs. 50.0%, P = .04).
DISCUSSION: Injury patterns, including bilateral rib fractures without pulmonary contusions and low but severe Injury Severity Score burden, may help identify high-risk patients who may benefit from closer monitoring and more aggressive therapy.
MATERIALS AND METHODS: A retrospective review of adult patients admitted to a Level 1 trauma center after blunt chest trauma between January 1, 2009 and December 31, 2013, was conducted. Patients with early respiratory failure were compared to patients with DRF using Fisher's exact tests, chi square, and Student's t-tests. A P-value of <.05 was considered significant.
RESULTS: 1299 patients had blunt chest trauma and at least 1 rib fracture, of which 830 met inclusion criteria. 5.8% of patients progressed to respiratory failure. Respiratory failure was delayed in 25% of these patients. DRF patients had significantly lower ISS (16.5 vs. 22.7, P = .04), more bilateral rib fractures (66.7% vs. 28.7%, P = .02) and fewer pulmonary contusions (16.7% vs. 50.0%, P = .04).
DISCUSSION: Injury patterns, including bilateral rib fractures without pulmonary contusions and low but severe Injury Severity Score burden, may help identify high-risk patients who may benefit from closer monitoring and more aggressive therapy.