title: [Emergency thoracotomy].
abstract: OBJECTIVE
  To determine indications for emergency (immediate and urgent) thoracotomies in cases of penetrating and blunt chest traumas.
  
  
  METHODS
  We performed retrospective analysis of treatment methods and results, achieved in 2927 patients treated for chest traumas in 1987-2000.
  
  
  RESULTS
  Algorithms for decision making in surgical management of chest traumas are drawn. Indications for emergency (immediate and urgent) thoracotomies are determined. Immediate thoracotomy was performed in 17.2% and 0.2% of patients, suffering from penetrating and blunt chest trauma respectively. Urgent thoracotomy underwent 7.6% due to penetrating and 2.7% due to blunt chest trauma. Postoperative mortality rate was much higher after immediate (20.0%) and urgent (10.9%) thoracotomy performed due to blunt chest traumas. In cases of penetrating chest traumas postoperative mortality rate was 3.3% and 3.0% after immediate and urgent thoracotomies respectively.
  
  
  CONCLUSIONS
  The effectiveness of surgical treatment of chest traumas depends on logical determination of indications for immediate or urgent thoracotomies. They should be undertaken in cases of severe damage of chest wall and/or internal organs and dangerous pathological syndromes.
authors.affiliation: Clinic of Thoracic Surgery, Kaunas University of Medicine, Lithuania. romaldasr@email.lt
authors.forename: Romaldas
authors.initials: R
authors.lastname: Rubikas
mesh_terms: D000465:Algorithms; D004630:Emergencies; D006491:Hemothorax / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000145:classification / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013908:Thoracotomy; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000601:surgery*; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000601:surgery*