Document Detail


Optimizing outcomes in emergency room thoracotomy: a 20-year experience in an urban Level I trauma center.
MedLine Citation:
PMID:  20420252     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Emergency room thoracotomy (ERT) has remained a last resort tool of resuscitation in the management of patients with major trauma. The medical records of all patients undergoing ERT for penetrating chest trauma from January 1, 2000 through April 30, 2008 were retrospectively reviewed. The data from this study were added to data collected in two previous studies conducted at our institution for meta-analysis. A total of 102 ERTs were performed. There were 28 Class I patients (27.4%), 58 Class II (56.8%), six Class III (5.8%), and 11 Class IV (10.7%). The number of ERTs performed on Class I patients has decreased from 58.3 per cent in the 1995 group to 35.4 per cent in the 1999 group. There was an overall survival of 7.8 per cent in the current period of review. Overall survival in the 1995 group was 2.5 per cent, 1999 was 2.7 per cent, and 2008 was 7.8 per cent. The majority of the survival benefit occurs in patients who have electrical activity and a blood pressure when examined in the emergency department (Class III and IV). We intend to do future prospective research to further clarify the Class II patients when evaluating the type of rhythm shown on electrocardiogram tracing to move away from the generic pulseless electrical activity category.
Authors:
Gerardo Gomez; Alison Fecher; Theresa Joy; Ivanesa Pardo; Lewis Jacobson; Heather Kemp
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  76     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-27     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  406-10     Citation Subset:  IM    
Affiliation:
Indiana University, Indianapolis, Indiana, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Chi-Square Distribution
Female
Humans
Male
Middle Aged
Patient Selection*
Retrospective Studies
Survival Rate
Thoracic Injuries / mortality,  surgery*
Thoracotomy*
Trauma Centers*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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