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Revista de cirugía

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

Resumo

GONZALEZ L., Roberto et al. Massive hemothorax by thoracic trauma in surgically treated patients. Rev. cir. [online]. 2020, vol.72, n.5, pp.434-440. ISSN 2452-4557.  http://dx.doi.org/10.35687/s2452-45492020005655.

Introduction:

Massive hemothorax (MH) can be defined as the sudden accumulation of ≥ 1500 ml of blood in the pleural cavity or debit ≥ 200 ml/h in 3-4 hours through pleurostomy, and it is considered a serious complication.

Aim:

To describe features, trauma severity indexes (TSI), morbidity and variables associated with mortality in patients with traumatic MH who required surgical treatment.

Materials and Method:

analytical longitudinal study. Period January 1981 to December 2018. Database, surgical protocols, medical records review. Description of MH characteristics. The following TSI were calculated: Injury Severity Score (ISS), Revised Trauma Score (RTS-T), Trauma Injury Severity Score (TRISS). An Odds Ratio univariate analysis was used for mortality.

Results:

Total 4306 TT, operated MH 119 (2.8%). Men were 112 (94.1%), average age 32 ± 13.2 years, 91 (76.5%) had isolated TT, 28 (23.5%) were associated with extrathoracic injuries and of these 23 (19.3%) were polytraumatized patients. Penetrating TT was 102 (85.7%). MH was mainly attributed to: chest wall injury in 38 (31.9%), pulmonary lacerations 29 (24.4%). Of the thoracic surgeries: 87 (73.1%) were urgent (≤ 4 h), 10 (8.4%) early (> 4-24 h) and 22 (18.5%) deferred (> 24 h). Average post operatory stay (days): 7.9 ± 6.4 According to TSI: average ISS 17.4 ± 9.6; RTS-T average 10.2 ± 2.7; TRISS average 12.7. Morbidity 46 (38.7%). Mortality 15 (12.6%).

Discussion:

MH is mainly attributed to chest wall injuries and pulmonary lacerations. Most of HM required urgent thoracic surgery. The observed mortality is similar to that expected one by TSI. There are variables associated with higher mortality in MH.

Palavras-chave : hemothorax; thoracic injuries; trauma severity indices; thoracic surgery; wounds and traumas.

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