ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
FACTORS EFFECTING MORTALITY IN TRAUMA THORACOTOMIES
Akın Eraslan BALCI, M. Nesimi EREN, Şevval EREN, Refik ÜLKÜ, Serdar ONAT, Erdoğan CEBECİ
Dicle Üniversitesi Tıp Fakültesi, Göğüs Kalp ve Damar Cerrahisi Anabilim Dalı, Diyarbakır
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
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