首页> 外文期刊>European journal of cardio-thoracic surgery: Official journal of the European Association for Cardio-thoracic Surgery >Management of 150 flail chest injuries: analysis of risk factors affecting outcome.
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Management of 150 flail chest injuries: analysis of risk factors affecting outcome.

机译:150连fl胸外伤的处理:影响预后的危险因素分析。

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摘要

OBJECTIVE: Flail chest continues to be an important injury with significant complications. The records of 150 patients presenting with flail chest injury were reviewed to determine risk factors affecting morbidity and mortality. MATERIAL AND METHOD: During a 7-year period 150 patients with a flail chest injury were admitted to our trauma center. There were 111 men (74%) and 39 women (26%) ranging in age from 18 to 88 years with a mean age of 56.9. Only 66 (44%) had an isolated flail chest injury on admission. The majority of patients were older than 55 years (n = 89, 59.3%), 80 (53.3%) presented with an hemo-, or/and pneumothorax, 36 (24%) sustained a head injury and 25 (16.7%) needed ICU monitoring. The mean ISS score was 38. Age, concomitant diseases, presence of pneumothorax and/or hemothorax, Severity Score (ISS), the need for mechanical support, length of stay and deaths were evaluated by using the t-test and chi2 test where appropriate. RESULTS: Sixty-seven patients (44.6%) were conservatively treated, while 80 (53.3%) needed thoracic drainage. Only in 6 cases (4%) thoracotomy was required, while in 9 (6%) laparotomy was performed. Mortality rate reached 5.3%. The main factors correlated with an adverse outcome were: ISS and the presence of associated injuries, while age, hemopneumothorax and mechanical support affected the length of hospitalization but not the mortality. CONCLUSIONS: (1) Age and hemopneumothorax did not affect mortality. (2) ISS was found to a strong predictor on outcome concerning morbidity and prolonged hospitalization but did not influence mortality rate. (3) Mechanical support was not considered a necessity for the treatment of flail chest.
机译:目的:连Fla胸部仍然是重要的损伤,并伴有严重的并发症。回顾了150例连fl胸外伤患者的记录,以确定影响发病率和死亡率的危险因素。材料与方法:在7年的时间里,有150例连fl胸外伤患者被收治到我们的创伤中心。年龄在18至88岁之间的男性为111位(74%)和39位女性(26%),平均年龄为56.9。入院时仅有66名(44%)患isolated连ail。大多数患者年龄超过55岁(n = 89,59.3%),80例(53.3%)患有血液或/和/或气胸,36例(24%)头部受伤,25例(16.7%) ICU监视。 ISS的平均得分为38。年龄,伴随疾病,气胸和/或血胸的存在,严重性得分(ISS),机械支持的需要,住院时间和死亡的评估通过适当的t检验和chi2检验进行。 。结果:保守治疗67例(44.6%),而胸腔引流80例(53.3%)。仅在6例(4%)中需要开胸手术,而在9例(6%)中需要进行剖腹手术。死亡率达到5.3%。与不良结局相关的主要因素是:ISS和相关伤害的存在,而年龄,血气胸和机械支持影响住院时间,但不影响死亡率。结论:(1)年龄和血气胸未影响死亡率。 (2)ISS被认为是与发病率和长期住院有关的结局的有力预测指标,但对死亡率没有影响。 (3)机械支持不被认为是治疗连treatment胸部的必要条件。

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