Document Detail

Outcome of isolated pulmonary contusion in blunt trauma patients.
MedLine Citation:
PMID:  8304646     Owner:  NLM     Status:  MEDLINE    
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)
S J Hoff; S D Shotts; V A Eddy; J A Morris
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  60     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  1994 Feb 
Date Detail:
Created Date:  1994-03-07     Completed Date:  1994-03-07     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  138-42     Citation Subset:  IM    
Department of Surgery, Vanderbilt University, Nashville, Tennessee 37212.
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MeSH Terms
Contusions* / complications,  mortality,  therapy
Injury Severity Score
Lung Injury*
Thoracic Injuries / complications,  mortality,  therapy
Wounds, Nonpenetrating* / mortality,  therapy

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