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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2017 October;83(10):1026-33

DOI: 10.23736/S0375-9393.17.11728-1

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Thoracic trauma and acute respiratory distress syndrome in polytraumatized patients: a retrospective analysis

Thomas HAIDER, Gabriel HALAT, Thomas HEINZ, Stefan HAJDU, Lukas L. NEGRIN

Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria


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BACKGROUND: Although thoracic trauma has often been associated with the development of acute respiratory distress syndrome (ARDS) in general, its impact on ARDS in combination with severe concomitant injuries has still to be elucidated. Therefore, the objective of this study was to determine the frequency of thoracic trauma and ARDS in polytraumatized patients, and to evaluate the impact of thoracic trauma on the occurrence and the onset of ARDS.
METHODS: Included in this retrospective cohort study were all polytraumatized patients over 18 years of age, with an injury severity score (ISS) of at least 16, who were admitted to our level I trauma center over a three-year time period.
RESULTS: Two hundred and eighty-eight patients met the inclusion criteria. 54.9% suffered from thoracic trauma, 51.7% developed ARDS, 21.5% pneumonia and 0.7% pulmonary embolism. Independent of the ISS, the presence of thoracic trauma increased the odds of ARDS occurrence (OR=2.242; 95% CI: 1.381-3.640; P<0.001) and resulted in a significantly earlier onset of ARDS (median, day 2 vs. day 3; P<0.01). Of those patients suffering from ARDS, ventilation time and length of stay at the ICU were longer if a concomitant thoracic injury was present (P<0.001). In general, ARDS was diagnosed prior to pneumonia and was therefore identified as its risk factor (OR=11.033; 95% CI: 4.812-25.299; P<0.001). Finally, an overall mortality rate of 21.2% was observed, which was neither affected by thoracic trauma nor ARDS.
CONCLUSIONS: Thoracic trauma was identified as major risk factor for ARDS occurrence and earlier onset in polytrauma victims.


KEY WORDS: Multiple trauma - Thoracic injuries - Adult respiratory distress syndrome - Complications - Lung injury

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Publication History

Issue published online: October 5, 2017
Article first published online: April 11, 2017
Manuscript accepted: April 1, 2017
Manuscript revised: March 2, 2017
Manuscript received: September 27, 2016

Cite this article as

Haider T, Halat G, Heinz T, Hajdu S, Negrin LL. Thoracic trauma and acute respiratory distress syndrome in polytraumatized patients: a retrospective analysis. Minerva Anestesiol 2017;83:1026-33. DOI: 10.23736/S0375-9393.17.11728-1

Corresponding author e-mail

lukas.negrin@meduniwien.ac.at