title: Video-assisted thoracoscopic surgery for posttraumatic hemothorax in the very elderly.
abstract: OBJECTIVE
  Thoracic injury is a life-threatening condition with advanced age being an independent risk factor for both higher morbidity and mortality. Furthermore, elderly patients often have severe comorbidity and in case of chest trauma with rib fractures and hemothorax, their clinical condition is likely to deteriorate fast. Aim of this study is to investigate the feasibility and results of video-assisted thoracoscopy for the treatment of posttraumatic hemothorax in very elderly patients of 80 years or more.
  
  
  METHODS
  The outcomes of 60 consecutive patients who received video-assisted thoracoscopic surgery for posttraumatic hemothorax in a German tertiary referral hospital between 2006 and 2010 were reviewed in a retrospective case study. Patients older than 80 years were identified.
  
  
  RESULTS
  There were 39 male and 21 female patients. The median age was 63.2 years. The in-hospital-mortality was 1.7% (1/60). Fifteen of the 60 patients were 80 years or older (80-91). Main reason for hemothorax was blunt chest trauma. Altogether 23 patients had fractures of three or more ribs including six octogenarians. Elderly patients suffered from preexisting cardiopulmonary disease and were often referred to the thoracic surgeon with considerable delay. Video-assisted thoracoscopic surgery was feasible and all octogenarian patients finally recovered well without in-hospital-mortality.
  
  
  CONCLUSIONS
  Video-assisted thoracoscopic surgery for treatment of posttraumatic hemothorax shows excellent results in very elderly patients of 80 years or more. Despite severe comorbidity and often delayed surgery all patients recovered. We therefore conclude that advanced age is no contraindication for surgical management of posttraumatic hemothorax by means of video-assisted thoracoscopy.
authors.affiliation: Klinikum Nürnberg Nord, Klinik für Allgemein, Viszeral, und Thoraxchirurgie, Nürnberg, Germany. michael.schweigert@klinikum-nuernberg.de
authors.forename: Michael
authors.initials: M
authors.lastname: Schweigert
authors.forename: Martin
authors.initials: M
authors.lastname: Beron
authors.forename: Attila
authors.initials: A
authors.lastname: Dubecz
authors.forename: Rudolf
authors.initials: R
authors.lastname: Stadlhuber
authors.forename: Hubert
authors.initials: H
authors.lastname: Stein
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005240:Feasibility Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006491:Hemothorax / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D012253:Rib Fractures / Q000209:etiology; D062606:Tertiary Care Centers; D013898:Thoracic Injuries / Q000150:complications; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications