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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 by firearms. Rev. cir. [online]. 2020, vol.72, n.4, pp.293-300. ISSN 2452-4557.  http://dx.doi.org/10.35687/s2452-45492020004586.

Background:

Thoracic trauma by firearms (TTF) are increasingly frequent.

Aim:

To describe clinical characteristics, morbidity and mortality and the evolution over time of patients hospitalized due TTF.

Materials and Method:

Longitudinal analytical study. Period January 1981 - December 2018. Database review, prospective protocols and clinical files. Microsoft Excel® spreadsheet and SPSS24® program with chi square and Mann-Whitney tests were used. Description of characteristics of TTF in hospitalized patients and comparison of TTF by periods. Trauma severity indexes (TSI) were calculated: Injury Severity Score (ISS), Revised Trauma Score (RTS-T), Trauma Injury Severity Score (TRISS).

Results:

Total: 4306 hospitalized patients due thoracic trauma (TT), 205 (4.8%) hospitalized due TTF. Men: 188 (91.7%), average age 28.8 ± 11.2 years, isolated TTF 115 (56.1%), associated with extrathoracic lesions 90 (43.9%), and of these 55 (26.8%) were considered polytraumatism. Mechanisms: aggression 193 (94.1%), self-harm 11 (5.4%) and accidental 1 (0.5%). Frequent thoracic injuries and/or findings: hemothorax 127 (62.0%), pneumothorax 96 (46.8%) and pulmonary contusion 51 (24.9%). Definitive treatment: Pleurotomy 88 (42.9%), surgery 71 (34.6%) and medical treatment 46 (22.4%). Median hospitalization 7 days. According TSI: Average ISS 16.7 ± 11.7, average RTS-T 11.1 ± 2.1, average TRISS 9.6. Morbidity: 44 (21.5%). Mortality: 14 (6.8%). There is an increase in polytraumatism and average TRISS, without changes in mortality.

Discussion:

The majority of TTF were isolated TT. Approximately one third of patients required surgery. The observed mortality is lower than expected. Changes in TTF were observed over time.

Palavras-chave : Firearms; trauma severity indices; thoracic injuries; penetrating wounds; thoracic surgery.

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