[Clinical features of thoracic injury; special reference to diaphragmatic injury].
We investigated the clinical feature of thoracic injury patients, mainly with diaphragmatic injury. From 1993 to 2005, 739 patients with thoracic injury were treated at our life-saving emergency center. There were more blunt trauma patients than penetrating injury patients (693 cases vs 46 cases). Regarding the thoracic injury patients, the causes of trauma were traffic injury in 462 (62.5%), unexpected accident including work place accident in 153 (20.7%), suicide in 90 (12.2%), and assault in 34 (4.6%). As the numbers of injured organs increased, the mortality rate increased. Among 156 patients with cardiopulmonary arrest on admission, 155 patients died. This result suggested that saving the life of patients presenting with cardiopulmonary arrest on admission is extremely difficult. Thirty-eight cases (5.1%) required surgical treatment, and surgery to repair diaphragmatic injury was performed in 14 cases. In 6 cases of diaphragmatic injury, thoracoscopy was performed during the examination and/or surgery.


CONCLUSIONS
Urgently transporting thoracic injury patients to hospital before the onset of cardiopulmonary arrest is therefore essential in order to reduce the mortality rate of these patients. In addition, thoracoscopy is very useful for both examining and treating traumatic diaphragmatic injury patients.
Yamasaki
Shigemichi
S
Emergency and Critical Care Center, Fukuoka University Hospital, Fukuoka, Japan.
Makihata
S
S
Hiratsuka
M
M
Hamatake
D
D
Yamamoto
S
S
Shiraishi
T
T
Iwasaki
A
A
Masuzaki
T
T
Tanaka
K
K
Shirakusa
T
T
D003964:Diaphragm / Q000293:injuries*; D004630:Emergencies; D006549:Hernia, Diaphragmatic, Traumatic / Q000601:surgery; D006801:Humans; D013898:Thoracic Injuries / Q000401:mortality / Q000601:surgery*; D013906:Thoracoscopy; D014949:Wounds, Nonpenetrating