Long-term followup after traumatic asphyxia

Victims of traumatic asphyxia syndrome were studied to determine: mechanism of injury, severity of injury, characteristic physical stigmata, treatment, and long-term disability. Consecutive patients who sustained severe crush injuries with traumatic asphyxia in the 5-year period ending November 1984 were reviewed. Followup was established by personal examination or questionnaire. Severity of injury and disability were assessed by Injury Severity Score and questionnaire, respectively. Six patients, ranging in age from 4 to 65 years, were hospitalized from 4 to 150 days for traumatic asphyxia. The mechanism of injury in each case was severe crush by an object weighing greater than 1,000 pounds. All patients had associated injuries, often involving the thorax, and the mean Injury Severity Score was 14.5. Severe craniocervical cyanosis with petechiae was present in all patients. Four patients had temporary neurologic impairment. Despite severity of injury, no long-term disability was detected at an average followup of 4.4 years. No long-term survivors demonstrated residual cyanosis, petechiae, swelling, or neurologic sequelae. All had returned to work or school.