Risk factors associated with postoperative complications of video-assisted thoracic surgery for traumatic hemothorax / 中华创伤杂志

ABSTRACT

Objective:To investigate the risk factors associated with the complications of video-assisted thoracic surgery (VATS) in the treatment of traumatic hemothorax.Methods:A retrospective case-control study was conducted to analyze the clinical data of 94 patients with traumatic hemothorax undergone VATS treatment in Tangdu Hospital of Air Force Medical University from January 1, 2012 to December 31, 2018. There were 75 males and 19 females, aged from 15-78 years [(45.8±14.6)years]. Postoperative complications occurred in 12 patients (complication group) and not in 82 patients (non-complication group). The following data were analyzed for complication-related risk factors using univariate analysis and Logistic regression analysis, including gender, age, mechanism of injury, pneumothorax and hemothorax, number of fractured ribs, abbreviated injury score (AIS), injury severity score (ISS), time from injury to operation, operation time, rib fixation or not, pulmonary air leakage or not, duration of drainage, postoperative volume of drainage, and postoperative length of hospital stay.Results:The proportion of patients with time from injury to operation (>3 days), duration of drainage and postoperative length of hospital stay in complication group [75%(9/12), (7.8±2.6) days, (10.2±2.7)days] were significantly higher or longer than those in non-complication group [37%(30/82), (5.5±1.6)days, (8.0±2.3)days] ( P<0.05 or 0.01). There were no statistically significant differences between the two groups in gender, age, mechanism of injury, pneumothorax and hemothorax conditions, number of fractured ribs (≥3), AIS, ISS, operation time, rib fixation or not, pulmonary air leakage or not and postoperative volume of drainage ( P>0.05). Logistic regression analysis showed time from injury to operation (>3 days) and pulmonary air leakage were significantly associated with the complications of VATS ( P<0.05). Conclusion:Time from injury to operation (>3 days) and pulmonary air leakage are independent risk factors for the complications of VATS in the treatment of traumatic hemothorax.