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Impact of blunt pulmonary contusion in polytrauma patients with rib fractures
Claire Miller1, Allan Stolarski1, Ashar Ata1
1Section of Trauma and Acute Care Surgery, Department of Surgery, Albany Medical Center, Albany, NY, USA.
Background:
We investigated the impact of blunt pulmonary contusion (BPC) in patients with rib fractures.
Methods:
Adult patients with rib fractures caused by blunt mechanisms were enrolled over 3 years at a Level 1 trauma center. BPC was defined according to percentage of lung affected as: moderate (1-19% contusion) or severe (≥20% contusion).
Results:
In total, 1448 of the 7238 admitted patients had rib fractures. Of these, 321 (22.2%) had BPC: 236 moderate and 85 severe. Patients with BPC were more likely to be admitted to the ICU (moderate: OR 1.55, 95% CI 1.10-2.19; severe: OR 2.74, 95% CI 1.41-5.32). Significantly increased rates of pneumonia (OR 2.52, 95% CI 1.43-4.90) and empyema (OR 4.80, 95% CI 1.07-21.54) were found for moderate and severe BPC, respectively.
Conclusions:
ICU admission and infectious pulmonary complications were more likely with BPC. The presence of BPC on admission CT is also prognostic of increased resource utilization.
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