Survival after emergency room thoracotomy in trauma patients

Abstract

Objective: To review and address survival rate of severe trauma patients who had undergone emergency room thoracotomies (ERT) Materials and Methods: Medical records of consecutive patients who received ERT in Songklanagarind Hospital between January 1996 and October 2006 were retrospectively reviewed. The study focused on factors potentially associated with survival, including sign of life (SOL), location of major organ injury (LOMI) and mechanism of injury (MOI). The data were reviewed and reported descriptively. Results: Thirty patients, 24 male and 6 female, underwent ERT during the study period. The average age was approximately 30.83 years (12-61 years). The MOI were penetrating in 15 cases; all of these were cases of male subjects. The majority (73%) of blunt injury was the result of motorcycle accident. The overall survival was 2/30 cases (6.7%) or 0/15 cases with blunt injury and 2/15 cases (13.3%) with penetrating injury. It should be noted that both of the patients who survived had isolated penetrating chest injury (cardiac injury). Considering SOL, there was no survival in patients who presented with null SOL. Conclusion: ERT provided a chance to recue selected cases of chest trauma. Our data suggest that favorable candidates for ERT are patients who sustain isolated penetrating thoracic injury.

Keywords

• emergency room thoracotomy
• resuscitative thoracotomy
• penetrating chest injury
• blunt chest injury