A population-based study on pneumothorax in severely traumatized patients.
BACKGROUND
Pneumothorax (PNX) is a recognized cause of preventable deaths in trauma patients. Our objective was to determine the incidence of traumatic PNX, the characteristics of its victims, and the treatment they receive.


METHODS
The study consisted of data set of a population-based study on major trauma.


RESULTS
The incidence of PNX was 81 per 1 million population per year, mostly caused by transport accidents. PNX victims generally had multiple injuries, and they showed on-scene clinical parameters worse than victims of other chest injuries of comparable severity. Fifty-three percent of PNXs were drained during the prehospital and early (< 2 hours) hospital course. There was no uniformity of treatment among different types of rescue facilities, some of them never performing decompression despite clinical need. The z statistic for mortality was -0.63.


CONCLUSIONS
PNX can be expected in one in five major trauma victims found alive. PNX is associated with a peculiar on-scene instability. Early decompression is often required. The effects of wider access to prehospital decompression and the reasons for its uneven availability in our setting need elucidation. Nevertheless, the present mortality follows the international standards.
Di Bartolomeo
S
S
Emergency and ICU Department, Azienda USL Città di Bologna-Ospedale Maggiore, Bologna, Italy.
Sanson
G
G
Nardi
G
G
Scian
F
F
Michelutto
V
V
Lattuada
L
L
D000704:Analysis of Variance; D004322:Drainage / Q000379:methods; D004632:Emergency Medical Services / Q000592:standards*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D011030:Pneumothorax / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000601:surgery; D011787:Quality of Health Care; D012189:Retrospective Studies; D012306:Risk; D018709:Statistics, Nonparametric; D013898:Thoracic Injuries / Q000150:complications*; D013997:Time Factors