Background: In our clinic, mortality caused by chest trauma in patients with thoracotomy was 13.9% (42/303), and 7.4% (286/3863) in patients without thoracotomy (p < 0.05). To explore this higher mortality in thoracotomy after trauma, properties of patients and injuries were analysed.

Methods: Patients with chest trauma and treated with or without thoracotomy were seperated into 3 groups according to injury severity score (ISS) (Group I: 0-25; Group II: 25-50; Group III: 50-75); rates and mortality of both groups were recorded. Relationship between increasing in ISS and mortality was explored.

Results: Factors that effected on mortality were blunt trauma, ribs fractures more than 3, bilaterally or massive pulmoner contusion with air leaks bleeding more than 1250 ml postoperatively, operation within 2 hours after injury, bilateral or total pneumothorax, associated head or abdominal injury and recussitation before thoracotomy. Rates of patients ISS I and II were not different (p = 0.29). But ISS III patients were in higher number among patients with thoracotomy (p < 0.05). Mean ISS was 32.8 ± 12.8 in thoracotomies and 24.2 ± 9.6 in nonthoracotomies. Mortality rising according to ISS was correlated in both groups (r = 0.964).

Conclusions: Cause of higher mortality in trauma treated with thoracotomy was depent on the severity of trauma. In selected patients it is not avoided to perform thoracotomy.

Keywords : Chest trauma, thoracotomy