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Blunt Thoracic Trauma: Analysis of 1730 Patients

Cemal Kahraman, MD, Kutay Tademir, MD, Yiit Akçali, MD, Fahri Ouzkaya, MD, Naci Emiroullari , MD, Mehmet Bilgin, MD

Department of Thoracic and Cardiovascular Surgery Erciyes University Medical Faculty Kayseri, Turkey

For reprint information contact: Cemal Kahraman, MD Mustafa Kemal Paa Bulvari Hakan Sitesi No. 23 Kayseri 38010, Turkey Tel: 90 352 437 4242 Fax: 90 352 222 3272

Between 1978 and 1997, 1730 patients with blunt thoracic trauma were treated in our department. There were 450 females and 1280 males. The mean age was 34.3 years ranging from 2 months to 80 years. The most frequent causes of trauma were motor vehicle accidents in 1438 patients and occupational accidents in 232. Injury to multiple intrathoracic structures was noted in 986 (57%) cases. There were associated injuries to the abdomen (13.76%), the head (23.35%), and the skeletal system (22.6%). Eighty-nine percent of the blunt thoracic traumas did not require open thoracotomy but immediate use of lifesaving measures such as closed tube thoracostomy for hemothorax or pneumothorax was necessary in 1543 cases. A laparotomy was carried out in 238 patients. The most common blunt thoracic traumas requiring immediate thoracotomy were massive hemothorax (33 cases), cardiac tamponade (2 cases), and massive tracheobronchial air leak (24 cases). Surgical intervention was necessary in 22 patients with diaphragmatic rupture and in 5 patients with isolated sternal fractures. During the posttraumatic period, adult respiratory distress syndrome occurred in 71 patients, pleural thickening in 29, and pleural empyema in 21 patients. The most common causes of morbidity were atelectasis (10.06%) and pneumonia (5.32%). The mean hospital time for all patients was 15 days and the mortality rate was 5.61%.