Evaluation of Thoracic Trauma in the Emergency Department

Abstract

Aim: The aim of this study was to evaluate patients with thoracic trauma in the emergency unit, to detect life-threatening injuries, and to plan a treatment method. Material and Method: The patients were investigated with regard to age, gender, cause of trauma, clinical findings and level of consciousness, intrathoracic pathologies, accompanying injuries, seasonal relations of the traumas, treatments and surgical interventions, morbidity, and mortality. Results: Among the 251 patients enrolled in the study, 224 (89.2%) were male and 27 (10.8%) were female; the mean age was 42.5 years (range: 6-91) among women and 36.4 years (range: 9-85) among men. The type of trauma was blunt thoracic trauma in 183 patients (72.9%) and penetrating thoracic trauma in 68 (27.1%). The most common causes of trauma were in-vehicle accidents in 82 (32.7%) and falls from heights in 56 (22.3%). Parenchymal thoracic pathologies were hemopneumothorax in 134 (53.4%) patients, pulmonary contusion in 102 (44.6%), pneumothorax in 75 (29.9%), and hemothorax in 40 (16%) patients. 232 (92.4%) of the cases were conscious, whereas 18 (7.2%) had varying levels of consciousness between somnolence and coma. The treatment methods included tube thoracostomy in 219 (87.6%) patients, thoracotomy in 16 (6.4%), and lobectomy in 1 patient. Mortality was observed in 2.4% of the cases (6 cases). Discussion: Since thoracic traumas may lead to mortality and can be accompanied by injuries including multiple systems, patients should be evaluated by a multidisciplinary team experienced in traumas, and treatment should begin immediately.