Unilateral post-traumatic pulmonary contusion: findings of a review.
OBJECTIVE
There is still much controversy regarding the optimal treatment for pulmonary contusion. Therefore, we examined the variables affecting patient outcomes over a 10-year period.


METHODS
We retrospectively reviewed 107 consecutive patients with a mean age of 28 years, who were treated for pulmonary contusion during a 10-year period. Pulmonary perfusion scans were obtained for 11 patients. We used a pulmonary contusion score (PCS) of one-third of a lung = 3 and the entire lung = 9.


RESULTS
Overall mortality was 15%, which increased to 24.4% in patients with a PCS of 7-9. The time taken for contusions to resolve was longer based on scan results than chest X-rays (42.6 vs 15.5 days, respectively). Concomitant thoracic injures were present in 64.5% of patients, and 29% had a flail chest. The factors predictive of mortality were age >/=60 years, an injury severity score (ISS) >/=25, transfusion of >/=4 units of blood, a PaO(2)/FIO(2) ratio of <300, concomitant flail chest, and a PCS of 7-9. The predictors for mechanical ventilation were age >/=60 years, concomitant flail chest, a PCS of 7-9, and an ISS >/=25. Mortality and the need for mechanical ventilation were higher in patients with nonisolated contusions than in those with isolated contusions.


CONCLUSIONS
Optimizing patient outcome requires prompt diagnosis, appropriate maintenance of fluid volume, and selective mechanical ventilation.
Balci
Akin Eraslan
AE
Department of Thoracic and Cardiovascular Surgery, Dicle University School of Medicine, Diyarbakir, 21280, Turkey.
Balci
Tansel Ansal
TA
Eren
Sevval
S
Ulkü
Refik
R
Cakir
Omer
O
Eren
Nesimi
N
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003288:Contusions / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D055370:Lung Injury; D008297:Male; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis; D013898:Thoracic Injuries / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D014421:Turkey / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000401:mortality / Q000628:therapy