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Risk factors for posttraumatic empyema in diaphragmatic injuries
Alberto Federico García1,2,3, Fernando Rodríguez4,5, Álvaro Sánchez6
1Division of Trauma and Acute Care Surgery, Department of Surgery, Department of Intensive Care, Fundación Valle del Lili, Cra 98 No. 18-49, 760032, Cali, Colombia. alberto.garcia@fvl.org.co.
World Journal of Emergency Surgery : WJES
|September 13, 2022
Summary
Penetrating diaphragmatic trauma increases empyema risk. Higher thoracic injury severity and visible contamination are key risk factors for developing posttraumatic empyema following diaphragmatic injuries.
Area of Science:
- Trauma Surgery
- Thoracic Surgery
- Critical Care Medicine
Background:
- Penetrating diaphragmatic injuries (PDIs) frequently lead to posttraumatic empyema.
- Understanding risk factors is crucial for managing these complex injuries.
Purpose of the Study:
- To identify independent risk factors for posttraumatic empyema in patients with PDIs.
- To analyze the impact of trauma severity, organ injury, contamination, and surgical management on empyema development.
Main Methods:
- Retrospective review of 192 patients surviving >48 hours post-PDI repair.
- Univariate and multiple logistic regression analyses to determine risk factors.
- Analysis included trauma scores, injury types, contamination levels, and thoracic management strategies.
Main Results:
- Empyema occurred in 5.7% of patients.
- Independent risk factors for empyema included thoracic Abbreviated Injury Scale (AIS) > 3 (OR 6.4) and visible contamination (OR 5.13).
- Specific organ injuries and thoracic contamination management methods did not significantly impact empyema risk.
Conclusions:
- Thoracic injury severity and visible abdominal contamination are significant independent risk factors for empyema post-PDI.
- These findings aid in risk stratification and targeted prevention strategies for posttraumatic empyema.
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