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Pulmonary resection for lung trauma

K C Stewart1, J D Urschel, S S Nakai

  • 1Department of Surgery, University of Alberta, Edmonton, Canada.

The Annals of Thoracic Surgery
|June 1, 1997
PubMed
Summary
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Pulmonary resection for trauma is uncommon, with a lower overall mortality than previously thought. However, pneumonectomy carries a high risk, and blunt trauma is associated with increased mortality.

Area of Science:

  • Thoracic Surgery
  • Trauma Surgery
  • Surgical Outcomes Research

Background:

  • Pulmonary resection for traumatic injuries is an infrequent procedure.
  • Existing literature suggests a high mortality rate associated with pulmonary resections in trauma patients.

Purpose of the Study:

  • To evaluate the incidence, indications, and outcomes of pulmonary resections following thoracic trauma.
  • To compare mortality rates between different mechanisms of injury and types of pulmonary resection.

Main Methods:

  • A 10-year retrospective review of patients undergoing pulmonary resection for trauma.
  • Data collected included patient demographics, injury severity score (ISS), mechanism of injury, indications for surgery, type of resection, and mortality.

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Main Results:

  • Of 2,455 chest trauma patients, 32 (1.3%) required pulmonary resection.
  • Hemorrhage was the primary indication for thoracotomy (24 patients).
  • Overall mortality was 12.5%, with significantly higher mortality in blunt trauma (33%) versus penetrating trauma (0%) (p < 0.02) and higher ISS in non-survivors (44.2) compared to survivors (21.6) (p < 0.001).

Conclusions:

  • Pulmonary resection for lung injury is rare, and overall mortality is lower than previously reported.
  • Pneumonectomy, though performed in few cases, demonstrates a high mortality rate (50%).
  • Blunt trauma and higher injury severity scores are associated with increased mortality, highlighting the impact of associated injuries on outcomes.