Incidence and treatment modalities of tracheobronchial injuries in Germany.
This study presents the first systematic data collection on incidence and therapeutic management of both iatrogenic and non-iatrogenic tracheal lacerations in Germany. In this survey (n=231 questionnaires) based on the geographical coverage of the country, the representation of all levels of service, and the inclusion of specialized thoracic departments as well as non-specialized surgical departments, a representative conspectus on the management of tracheal injuries in Germany was developed. A total number of 1033 tracheal injuries were reported; n=429 of non-iatrogenic origin (blunt trauma: n=276, penetrating wounds: n=94, bullet wounds: n=16, other etiology: n=43) and n=604 of iatrogenic origin (endotracheal intubations/mechanical ventilation: n=372, dilative tracheotomy: n=181, endoscopic interventions: n=51). In institutions of high level of service there was a trend towards higher rates of surgical repair as opposed to conservative management. On the basis of these data the estimated risk of tracheal lacerations, due to single lumen intubation was 1:75,000 (0.000013%); the risk of clinically significant tracheal lacerations due to dilative tracheostomy 1:575 (0.002%) and lacerations requiring surgical treatment 1:975 (0.001%). Data of this survey state that specialized thoracic surgeons to a high proportion are involved in the management of both iatrogenic and non-iatrogenic tracheal injuries.
Schneider
Thomas
T
Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
Volz
Kathrin
K
Dienemann
Hendrik
H
Hoffmann
Hans
H
D001980:Bronchi / Q000293:injuries / Q000601:surgery; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006757:Hospital Units; D006785:Hospitals, University; D006801:Humans; D007049:Iatrogenic Disease; D015994:Incidence; D022125:Lacerations / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D018570:Risk Assessment; D012307:Risk Factors; D013043:Specialties, Surgical / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D019616:Thoracic Surgical Procedures / Q000706:statistics & numerical data; D014132:Trachea / Q000293:injuries / Q000601:surgery; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology / Q000601:surgery