Evaluation of Lung Contusion, Associated Injuries, and Outcome in a Major Trauma Center in Shiraz, Southern Iran.

Parviz Mardani,Reza Shahriarirad,Armin Amirian,Keivan Ranjbar,Mohammad Moayedi Rad,Shahram Paydar,Amirhossein Erfani,Jacek Smereka

doi:10.1155/2021/3789132

Parviz Mardani, Reza Shahriarirad + Show 6 more

Open Access

https://doi.org/10.1155/2021/3789132

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Abstract

Objective Blunt chest trauma as one of the most common injuries in trauma cases can cause significant morbidity and mortality. The purpose of this study was to determine the clinical course of traumatic injuries with an initial diagnosis of a pulmonary contusion in patients. Method In this retrospective study, we evaluated the demographic and clinical features of patients who were referred to a major trauma center in southern Iran. In our study, patients were enrolled with the diagnosis of pulmonary contusion. All included patients were above 16 years of age, with an initial CT scan in favor of pulmonary contusion, while patients not being hospitalized for more than 48 hours were excluded from the study. Results Among the 434 patients included in our study, 366 (84%) were male and the mean age was 41.17 (SD = 17.89). Among them, the majority (80.4%) had right side lung contusion and 47 patients (10.8%) had right rib fracture. The most common injuries were head and neck injury (56.9%) and limbs (30%). In 25% of cases, pulmonary contusion was associated with pneumothorax and 15.8% with hemothorax. Also, 49.6% of patients were transferred to the ICU. The mortality rate in our study was 15.2% (n = 66). Conclusion Although recent advances in pulmonary care and ventilator management have been achieved, there is still considerable morbidity and mortality associated with this condition. Therefore, there is a need to provide a national guideline based on native patient information for better management.

Highlights

Blunt chest trauma is considered as one of the most common problems of health practice, especially with the increase of road traffic accidents accounting for almost 15% of trauma cases [1]
We retrospectively evaluated all trauma patient records admitted to Shahid Rajaee Hospital cardiopulmonary cerebral resuscitation (CPCR) room from 2016 to 2018
Patients who were transferred to the intensive care unit (ICU) had an average length of stay of 7.69 days. e mortality rate in our study was 15.2% (66 patients)

Summary

Introduction

Blunt chest trauma is considered as one of the most common problems of health practice, especially with the increase of road traffic accidents accounting for almost 15% of trauma cases [1]. The majority of thoracic bony structure fractures are nonthreatening and can be managed with no hospital admission, chest injury itself can be the primary cause of death in patients with multiple trauma and its complications responsible for more than 25% of deaths in patients with blunt trauma [2]. One-third of patients with thoracic trauma develop rib fractures, which increases the risk of death and disability as the number of fractured ribs increases [3]. Complications such as pneumonia, sepsis, multiorgan failure, hemorrhagic shock, and pneumomediastinum (caused by the Macklin effect) have been reported in other studies [4, 5].

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