Treatment efficacy of damage control strategy in elderly patients with multiple injuries combined with thoracic trauma

Abstract

Listen

Translate article

Objective To investigate the efficacy of damage control strategy in treating elderly patients with multiple injuries combined with thoracic trauma and evaluate its efficacy. Methods A retrospective case-control study was performed to analyze the data of 877 elderly patients with multiple injuries combined with thoracic trauma admitted from January 2005 to December 2016. There were 574 males and 303 females, aged 65-94 years (mean, 70.8 years). The patients were divided into damage control group (n=406) and non-damage control group (n=471), according to the application of damage control strategy. The injury severity score (ISS) of the damage control group and the non-damage control group were (14.4±8.5)points and (13.7±9.4)points, respectively. The emergency operation rate within 24 hours, the blood loss during emergency operation, the thoracic and abdominal surgery, vascular interventional embolization, thoracic fracture and limb pelvic fracture operation within 72 hours, as well as ICU treatment rate, treatment time, complications, and prognosis were compared between the two groups. Results Fifty-one cases (12.6%)in the damage control group and 93 cases (19.7%)in the non-damage control group underwent emergency operation within 24 hours(P 0.05), the incidence of arrhythmia and heart failure were 53.4% and 60.5% (P<0.05), and the incidence of respiratory failure and ARDS were 17.7% and 23.8% (P<0.05). A total of 29 cases died in the damage control group (7.1%) and 53 cases died in the non damage control group (11.3%) (P<0.05). Conclusions Damage control strategy should be applied to treating elderly patients with multiple injuries combined with chest injury. By simplifying or reducing emergency surgery, active ICU treatment, and focusing on the fixation of chest fractures, damage control strategy can effectively reduce complications and improve survival rate. Key words: Aged; Multiple trauma; Thoracic injuries; Damage control