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- Title
Survival outcomes of emergency thoracotomy in severely injured patients performed by a general surgeon at a rural university hospital in Thailand.
- Authors
Tullavardhana, Thawatchai
- Abstract
Background: Emergency thoracotomy is a potentially life-saving maneuver for trauma patients in extremis. Since trauma scenarios, in rural locations, usually occur with a high incidence of a severe injury that leads to hemorrhagic shock or cardiopulmonary arrest. The objective of this study was to analyze the experience in emergency thoracotomy performed by a general surgeon in a rural area in Thailand. Methods: This retrospective study was conducted by analyzing the patient records including demographics, mechanisms of injuries, specific organ injury, surgical approach, life-saving surgical procedure, and postoperative outcome for all patients who underwent emergency thoracotomy in the Department of Surgery, Srinakharinwirot University hospital between January 2010 and December 2020. Results: Twelve patients underwent emergency thoracotomy within 1 hour after arrival and were equally divided between blunt and penetrating injuries with 6 (50%). A mean patient age of 34.8 ± 15.2 years (range 16-55), mean systolic blood pressure on arrival was 65.8 ± 35.2 mmHg (range 0-100 mmHg), and the mean injury severity score (ISS) was 54.6 ± 25.2 (range 26-75). Profound hemorrhagic shock is a major indication for emergency thoracotomy. The overall survival rate was 41.7% (5/12 patients) without survivors from cardiac injuries. Four patients (66.7%) in the penetrating and 1 patient (16.7%) in the blunt intrathoracic injury group were survived and discharged from the hospital. Conclusion: Emergency thoracotomy offers a chance for survival at 41.7% for trauma patients who present with extremes in this study. Rapid decision-making, good operative technique, and adequate patient selection are crucial for reasonable outcomes.
- Subjects
THAILAND; TRAUMA surgery; RURAL hospitals; ACADEMIC medical centers; WORK; SYSTOLIC blood pressure; THORACOTOMY; PATIENTS; PHYSICIANS' attitudes; RETROSPECTIVE studies; ACQUISITION of data; EPIDEMIOLOGY; SEVERITY of illness index; TREATMENT effectiveness; EMERGENCY medical services; EXPERIENTIAL learning; SURVIVAL analysis (Biometry); MEDICAL records; POSTOPERATIVE period; DESCRIPTIVE statistics; WOUNDS &; injuries; DISCHARGE planning; EVALUATION
- Publication
Journal of Emergency Medicine, Trauma & Acute Care, 2022, Vol 2022, Issue 2, p1
- ISSN
1999-7086
- Publication type
Article
- DOI
10.5339/jemtac.2022.7