[Indicators of severity in chest trauma].
OBJECTIVE
We undertook a review of patients with chest trauma attended between January 1992 and June 2005 in order to establish severity criteria in these cases.


METHODS
During the study period, 1,772 cases (1,346 [76%] males) were treated, with ages ranging from 7 to 98 years (mean, 46.4 years). The Revised Trauma Score (RTS) was calculated and the following variables were also studied as potential indicators of severity: age, extent of the injury, number of rib fractures, presence of lung contusion, hemothorax, cardiorespiratory repercussions, and need for mechanical ventilation.


RESULTS
At the time of admission, 84.4% of patients presented only symptoms related to the injury, with no general repercussions, and 66.7% had an RTS of 12. The number of rib fractures was a reliable indicator of severity, as was the presence of multiple injuries, lung contusion, need for mechanical ventilation, and cardiorespiratory repercussions. Neither age nor presence of hemothorax was found to be an indicator of severity. Pleural drainage was performed in 756 cases and was effective in 670 (88.6%).


CONCLUSIONS
There are a number of indicators of severity in chest trauma, related more closely to the type and repercussions of the trauma than to the age of the patient. There is a high incidence of fluid or gas accumulation in the pleural space, though this can be easily managed by pleural drainage, which constitutes the main therapeutic procedure in chest trauma.
Freixinet
Jordi
J
Servicio de Cirugía Torácica, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, España.
Beltrán
Juan
J
Rodríguez
Pedro Miguel
PM
Juliá
Gabriel
G
Hussein
Mohammed
M
Gil
Rita
R
Herrero
Jorge
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006491:Hemothorax / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial; D012253:Rib Fractures / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D013898:Thoracic Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy