Analysis of patients requiring urgent thoracotomy

We aimed at investigating the effects of clinical data, urgent thoracotomy (UT) indications and results on prognosis and mortality in traumatic and non-traumatic patients who were and underwent UT in the operating room.

Patients (17-90 years old) who were admitted to the Emergency Department of Afyonkarahisar State Hospital between 01.01.2012 and 31.06.2020 with traumatic and non-traumatic reasons requiring UT were retrospectively conducted from the archive. The patients' age, gender, complaints during admission, trauma classification, reports of thorax images, injury sites accompanying trauma, hospitalization and mortality rates were examined. IBM SPSS 22.0 program was used to compare all the data obtained.

During the 90-month study period, a total of 40 patients who were admitted for traumatic and non-traumatic reasons were applied UT. The mean age of all patients (77.5% male, 22.5% female) was 33.35±14.1 years. There were 55% penetrating injuries, 32.5% blunt injuries and 12.5% non-traumatic causes. Indications for UT in the study were; massive hemothorax (25%), diaphragmatic rupture (22.5 %), hypovolemic shock (25%), heart or great vessel injuries (15%), massive air leak despite thoracostomy (10%), rupture of the pulmonary hydatid cyst into the bronchus and accompanying hemoptysis (2.5%). The time to surgical procedure in patients who underwent thoracotomy was shorter in patients with death. Mean time to thoracotomy was 4.5±6.5 hours. Mortality of UT was 20% with survival of 80%.

In the context of indications, urgent thoracotomy reduces mortality. The cooperation between the emergency physician and the thoracic surgeon is important during the decision phase.