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Penetrating chest trauma: a 20-year experience
R Baillot1, L Dontigny, A Verdant
1Department of Cardiovascular and Thoracic Surgery, Hôpital du Sacré-Coeur, Université de Montréal, Québec, Canada.
The Journal of Trauma
|September 1, 1987
Summary
Penetrating chest trauma (PCT) predominantly affects young adults, often from gunshot wounds. While mediastinal injuries had zero mortality, thoracic injuries showed significant mortality, with shock and infection as key complications.
Area of Science:
- Trauma Surgery
- Thoracic Surgery
- Emergency Medicine
Background:
- Penetrating chest trauma (PCT) presents a significant challenge in urban settings.
- A 20-year study (1965-1985) at Sacré-Coeur Hospital, Montreal, analyzed PCT patient demographics and outcomes.
Purpose of the Study:
- To evaluate the treatment strategies and outcomes for patients with penetrating chest trauma.
- To identify factors influencing morbidity and mortality in PCT patients.
Main Methods:
- Retrospective analysis of 76 patients diagnosed with PCT.
- Classification of injuries into thoracic (T) and mediastinal (M) groups.
- Comparison of surgical versus conservative management and associated outcomes.
Main Results:
- The majority of patients were young adults, with gunshot wounds being the most common cause.
- Thoracic injuries (88.1%) had a mortality rate of 11.9%, while mediastinal injuries (11.8%) had 0% mortality.
- Shock increased morbidity and mortality in the thoracic group; infection was the most frequent complication overall.
Conclusions:
- Mediastinal penetrating chest trauma, when managed surgically, demonstrates excellent survival rates.
- Thoracic penetrating chest trauma requires careful management, with shock and infection being critical factors impacting outcomes.
- The rising incidence of PCT suggests increasing urban violence.