| Outcome of isolated pulmonary contusion in blunt trauma patients. | |
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MedLine Citation:
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PMID: 8304646 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To determine outcome in young, healthy blunt trauma patients with isolated pulmonary contusion, and to identify factors associated with poor outcome, we reviewed 6012 consecutive adult (aged 16-49) blunt trauma admissions. Ninety-four (7.9%) presented with an isolated pulmonary contusion defined by chest radiograph and Injury Severity Score < 25; they compromise the study group. Poor outcome was defined as death, prolonged hospitalization (> 7 days), or a severe complication (pneumonia, empyema, atelectasis requiring bronchoscopy, or bronchopleural fistula). None of the 94 study patients died. Admission chest radiograph demonstrated no contusion in 34 patients (36%). Fifteen patients (16%) required intubation, but 13 were extubated within 48 hours. Forty-one patients (44%) required insertion of a chest tube, and 20 patients (21%) had a PaO2/FiO2 ratio of < 250 on admission. Post-injury atelectasis (n = 17), pneumothorax (n = 17), effusion (n = 8), pneumonia (n = 2), empyema (n = 1), and Staphylococcal bacteremia (n = 1) complicated hospitalizations. The following clinical factors were identified as predisposing to poor outcome by univariate analysis: 1) Pulmonary contusion on admission chest radiograph (P = 0.035); 2) Three or more rib fractures (P = 0.002); 3) chest tube insertion (P = 0.010) and drainage (P = 0.020); and 4) hypoxia on admission (PO2 < 70 torr [P = .021], PaO2/FiO2 < 250 [P < 0.001]). Only PaO2/FiO2 < 250 on admission was an independent predictor of poor outcome in a multivariate analysis (P = 0.040). Our conclusion was that isolated pulmonary contusion in young, healthy patients is not associated with mortality.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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S J Hoff; S D Shotts; V A Eddy; J A Morris |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American surgeon Volume: 60 ISSN: 0003-1348 ISO Abbreviation: Am Surg Publication Date: 1994 Feb |
Date Detail:
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Created Date: 1994-03-07 Completed Date: 1994-03-07 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0370522 Medline TA: Am Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 138-42 Citation Subset: IM |
Affiliation:
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Department of Surgery, Vanderbilt University, Nashville, Tennessee 37212. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Contusions* / complications, mortality, therapy Female Humans Injury Severity Score Lung Injury* Male Prognosis Thoracic Injuries / complications, mortality, therapy Wounds, Nonpenetrating* / mortality, therapy |
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