Pulmonary Contusion: Evaluation of Associated Injuries, Clinical Course, and Outcomes; Self¬ Experience from a Tertiary Care Center
Keywords:
Pulmonary contusion, blunt chest trauma, Rib fractures, Pneumothorax, Hemothorax, thoracic.Abstract
Background:Even with current advances in our consideration of the pathophysiology, therapy, and long-term outcomes of lung injuries, still, statistics on the frequency, associated injuries, clinical course, and outcome of pulmonary injuries in Iraq insufficient. Henceforth, this self-experience study aimed to fill this gap.Methods: The study’ data were taken retrospectively, from the archives of 100-admitted lung contusion patients. History, clinical examination, radiographic, operative and post-mortem findings were used.Results: A total of 100 patients with chest trauma met the criteria of this study, with a mean age of 31.4 years, most were males (92%) included. The average hospitalization duration was 23 days. The in-hospital death rate was 14%. Pneumothorax was detected in 40% of the patients, 22% hemopneumothorax and 12% of them showed hemothorax alone. Half of the patients had no associated rib fractures and 32% reported > 4 rib fractures while 20% had < 4 fractured ribs. There was a nearly equal incidence of penetrating and non-penetrating injuries. Around 50% of the pulmonary contusion cases were associated with extra-pulmonary associated injuries. Almost all of the cases of lung contusion required chest tubes (74%), 62% required bilateral chest tubes, and only 12% had unilateral tubes. Seventy-four percent required RCU care, 28% needed endotracheal intubation, and 13% ended with thoracotomy. More than half of the patients required surgery.Conclusion: The clinical course of pulmonary contusion remains unpredictable. Considerable morbidity and mortality are linked with pulmonary contusion despite the recent progress in respiratory care and ventilation services.
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