ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Factors affecting mortality in traumatic diaphragmatic ruptures
Taner Tarladaçalışır, Y. Altemur Karamustafaoglu, Yener Yörük
Department of Thoracic Surgery, Medical Faculty of Trakya University, Edirne, Turkey
DOI : 10.5606/tgkdc.dergisi.2014.8700
Background: This study aims to investigate possible factors affecting mortality in patients with traumatic diaphragmatic ruptures.

Methods: Between May 1997 and May 2009 a total of 30 patients (27 males, 3 females; mean age 42.6 years; range 16 to 88 years) were operated in our clinic with a diagnosis of traumatic diaphragmatic rupture. The patients were evaluated retrospectively in terms of possible factors affecting mortality. Emergency surgery was performed 22 patients within the first seven days. Other two patients were operated in the latent phase and six patients were operated in the obstructive phase.

Results: Thoracotomy was performed in nine patients, laparotomy in nine patients and thoracotomy + laparotomy in 12 patients. Eight patients were diagnosed by explorative laparotomy. The mean duration of hospitalization was 12 days (range, 1-50 days). Morbidity was observed in eight patients (27%), while mortality was seen in seven patients (23%). Five patients had no associated pathology, while various associated pathologies were observed in 25 patients. Additional surgical interventions were required for associated pathologies in 16 of these patients (53%). Older age (p=0.020) and need for longer length of stay in the intensive care unit (p=0.020) were found to be negative prognostic factors affecting mortality.

Conclusion: Associated organ injuries are the main prognostic factors which affect morbidity and mortality. Early weaning from mechanical ventilation, aggressive treatment and close follow-up of patients with elderly and those with organ injuries associated with traumatic diaphragmatic ruptures may reduce morbidity and mortality.

Keywords : Diaphragmatic; mortality; rupture; trauma
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