The factors affecting on mortality on isolated blunt thoracic trauma patients

Isolated blunt thoracic injury occurs with a localized, blunt trauma to the chest. The majorities of these cases are associated with mild injury like thoracic bruises and rib fractures. In contrast, severe thoracic trauma occurs in patients with multipl trauma. Mortality of isolated blunt thoracic trauma in adults is 0-5 % and in the elder mortality is 5-15 %. In the recent studies age older then 60, 3 or more rib fractures, injury severity score 25 and over, accompanying other systemic injuries, sole or double sided extensive contusion, surgery within the two ours after the injury time, total or double sided pnomothorax were the factors affecting on mortality. In this study we tried to evaluate the factors affecting on mortality on isolated thoracic trauma patients.The data of 211 patients suffering from thoracic trauma that were admitted to emergency department of Dicle university between may 2004 and august 2007 were prospectively analyzed and included to the study consecutively. All patient group were divided into survey group (n=188) and mortal group (n=23). The surveying group was named as group 1 and mortal group was named as group 2. Elder age, sex, happening way of trauma, late admission time, hypotension, anemia during admission, hypoxia in arterial blood gas, troponin I, CK, CK-MB, ECG dates during admission, pathologies existing in chest x-ray, admission trauma scores (GCS, RTS, İSS, TRSS, TTSS), duration of hospitalization, admission to the intensive care and the therapies applied were researched.173 of the patients were male and 38 of the patients were female the age of the patients included to the study was between 2-80. 188(89,1 % ) of the 211 patients were in group 1 and 23(10,9 %) of 211 was in group 2. General mortality was 10,9 % . We found that according to the results of univariety analysis GCS (P<0,0001), low GCS (P<0,0001), hypotension (P<0,0001), low hematocrit (P<0,005), İSS (P<0,001), RTS (P<0,0001), TRİSS (P<0,0001), TTSS (P<0,0001), high İSS (P<0,0001), troponin (P<0,0001), CK-MB (P<0,0001), ST segment depression(P<0,0001), abnormal ECG (P<0,0001), sinusal tachycardia (P<0,0001) , inversion of T wave on ECG (P<0,0001), admission to intensive care (P<0,0001), tube thoracostomy (P<0,05), ,hypoxia in arterial blood gas (P<0,0001), duration of hospitalization (P<0,002), jugular venous distention had meaningful affect on mortality.According to the multivariate analysis GCS (odds ratio, OR=4,77, 95 % confides interval, CI=1,072-3,627, p=0,029), hypotension (OR=5,34, CI=0,011-0,691, p=0,021), İSS (OR=4,74, CI=1,024-1,542, p=0,029), high İSS (OR=4,32, CI=1,233-1179,852, p=0,038), low hematocrit (OR=4,11, CI=1,008-1,549, p=0,043), CM-MB (OR=6,37, CI=0,972-0,996, p=0,012) were the most important independent variables affecting on mortality.