Emergency Thoracotomy in a Swedish Setting: A Consecutive Series of 45 Patients from a Scandinavian Trauma Hospital
- Corresponding Author:
- Hans Granehed
Assistant professor, Senior Consultant Surgeon
Specialist in Orthopedic and General Surgery Trauma Unit
Department of Surgery, Sahlgrenska University
Hospital, S-424 45 Gothenburg Sweden
E-mail: [email protected]
Received date: February 29, 2016; Accepted date: May 13, 2016; Published date: May 16, 2016
Citation: Beck J, Granehed H, Akyürek L, David P (2016) Emergency Thoracotomy in a Swedish Setting: A Consecutive Series of 45 Patients from a Scandinavian Trauma Hospital. J Trauma Treat 5:305. doi:10.4172/2167-1222.1000305
Copyright: © 2016 Beck J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Emergency thoracotomy (ET) has previously been studied and evaluated in an American and African perspective. The mechanism of injury (MOI) varies between different parts of the world. In the Northern European setting, blunt trauma is the most common MOI. Regarding penetrating thoracic injuries stab wounds compromises the majority whereas gunshot wounds (GSW) are relatively scarce. The aim of this study was to describe the situation at a Scandinavian Trauma Hospital. Method: This study was a retrospective case series involving all patients who underwent an ET between 2004 and 2011 at a single centre. Patients were identified and data collection of demographics, trauma scores and physiological values were retrieved from hospital charts and trauma registry. Statistical analyses were performed. Results: A total of 45 ET patients were identified. The patients were predominately male (82%), and severely injured with median ISS of 48. The overall survival rate was 31%. Blunt trauma accounted for 60% of the patients. Survival following penetrating thoracic trauma had a 50% survival rate, whereas blunt trauma had a 19% survival rate. Conclusion: The injury pattern preceding ET is different between America and Europe. Blunt trauma accounts for the majority of cases. Penetrating trauma is mostly caused by stab wounds which carry a better prognosis than gunshot wounds (GSW). There is clearly a value in performing ET for selected cases following penetrating thoracic violence. Most of the surviving cases of thoracotomy for blunt trauma were for aortic cross clamping to control abdominal bleeding. Isolated blunt trauma to the chest carried a dismal prognosis.