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Revista de cirugía

versão impressa ISSN 2452-4557versão On-line ISSN 2452-4549

Resumo

GONZALEZ L., Roberto et al. Thoracic trauma in the elderly. Rev. cir. [online]. 2020, vol.72, n.3, pp.224-230. ISSN 2452-4557.  http://dx.doi.org/10.35687/s2452-45492020003543.

Introduction:

Trauma is the fifth leading cause of death in the elderly (60 or older), with blunt trauma being the most frequent.

Objective:

To describe characteristics, Trauma Severity Indices (TSI) and morbidity and mortality in hospitalized elderly for Thoracic Trauma (TT).

Materials and Method:

Crosssectional descriptive study was carried out. Term: from January 1981 to December 2017. Database review, surgical protocols and medical records were performed. TT description of characteristics was conducted in hospitalized elderly. TSI was calculated: Injury Severity Score (ISS), Revised Trauma Score (RTS-T), Trauma Injury Severity Score (TRISS).

Results:

Total 4.163 TT, 513 elderly (12.3%). Men: 350 (68.2%), average age 71.2 ± 8.4 years, 70 median (range 60-103). Isolated TT: 350 (68.2%), 163 associated with extrathoracic trauma (31.8%) and of these 96 (18.7%) were considered polytraumatism. Blunt trauma 456 (88.9%) and penetrating 57 (11.1%). Most frequent domestic accident mechanism was 196 (38.2%) and 158 traffic accidents (30.8%). Frequently thoracic injuries or findings: 409 rib fractures (79.7%), 186 hemothorax (36.3%), and 185 pneumothorax (36.1%). Final treatment: 287 Medical treatment (55.9%), 193 pleurotomy (37.6%), and 40 thoracic surgery (7.8%). Extrathoracic surgery 33 (6.4%). Average hospitalization: 9.0 ± 8.8 days. According IGT: ISS 12.1 ± 9.6, RTS-T 11.6 ± 1.3, TRISS 8.1. Morbidity: 76 (14.8%) and mortality: 26 (5.1%).

Discussion:

Most TT in elderly are blunt, caused by domestic accidents. Injuries and most frequent findings were rib fractures and hemothorax. Mortality was lower than expected according to TSI.

Palavras-chave : elderly; thoracic trauma; trauma severity indices; thoracic surgery; geriatric trauma.

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