Prognostic Impact of Cardiovascular Injuries for Patients with Respiratory Isolated Chest Trauma

This study assessed the prognostic impact of cardiovascular injuries in patients with isolated chest trauma primarily involving the respiratory system.

We retrospectively reviewed the Japan Trauma Data Bank records (2004-2019). Patients with isolated chest trauma were categorized into the respiratory or cardiovascular injury group according to the highest abbreviated injury scale score. The effect of cardiovascular injuries in the respiratory injury group was analysed using a multivariable logistic regression analysis.

Among the 8048 patients in the respiratory injury group, those with minor cardiac injury had a higher mortality rate than those without (15% vs 7%; P = .027); those with severe vascular injury (most commonly thoracic aorta) had a 76% mortality rate. The multivariable analysis indicated older age (adjusted odds ratio [adjOR]: 1.01, 95% CI: 1.00-1.01, P = .016), penetrating injury (adjOR: 2.19, 95% confidence interval [CI]: 1.40-3.43, P = .002), higher new injury severity score (adjOR: 3.89, 95% CI: 3.16-4.78, P < .001), coexistence of cardiac (adjOR: 2.68, 95% CI: 1.51-4.76, P < .001) or vascular injuries (adjOR: 3.36, 95% CI: 1.93-5.83, P < .001), and tracheobronchial injuries (adjOR: 2.10, 95% CI: 1.15-3.82, P = .015) with the highest abbreviated injury scale scores were significantly associated with increased odds of in-hospital mortality.

Minor cardiac or severe vascular injuries significantly increased mortality in patients with isolated chest trauma primarily involving the respiratory system. Assessment of both respiratory and coexisting cardiovascular injuries is essential for clinical management.