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Factors Affecting Pneumonia Occurring to Patients with Multiple Rib Fractures
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 130-134, 2013.
Artigo em Inglês | WPRIM | ID: wpr-13796
ABSTRACT

BACKGROUND:

Rib fractures are the most common type of thoracic trauma and cause other complications. We explored the risk factors for pneumonia in patients with multiple rib fractures. MATERIALS AND

METHODS:

Four hundred and eighteen patients who visited our hospital with multiple rib fractures between January 2002 and December 2008 were retrospectively reviewed. Chest X-rays and chest computed tomography were used to identify injury severity. Patients with only a single rib fracture or who were transferred to another hospital within 2 days were excluded.

RESULTS:

There were 327 male patients (78%), and the median age was 53 years. The etiologies of the patients' trauma included traffic accidents in 164 cases (39%), falls in 78 cases (19%), slipping and falling in 90 (22%), pedestrian accidents in 30 (7%), industrial accidents in 41 (10%), and assault in 15 (4%). The median number of rib fractures was 4.8. Pulmonary complications including flail chest (2.3%), lung contusion (22%), hemothorax (62%), pneumothorax (31%), and hemopneumothorax (20%) occurred. Chest tubes were inserted into the thoracic cavity in 216 cases (52%), and the median duration of chest tube insertion was 10.26 days. The Injury Severity Score (ISS) and rib score had a median of 15.27 and 6.9, respectively. Pneumonia occurred in 18 cases (4.3%). Of the total cases, 33% of the cases were managed in the intensive care unit (ICU), and the median duration of stay in the ICU was 7.74 days. Antibiotics were administered in 399 patients (95%) for a median of 10.53 days. Antibiotics were used for more than 6 days in 284 patients (68%). The factors affecting pneumonia in patients with multiple rib fractures in multivariate analysis included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). The use of antibiotics was not associated with the occurrence of pneumonia (p=0.28). In-hospital mortality was 5.3% (n=22).

CONCLUSION:

The factors affecting risk of pneumonia in patients with multiple rib fractures included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). Elderly patients with multiple traumas have a high risk of pneumonia and should be treated accordingly.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Pneumonia / Pneumotórax / Fraturas das Costelas / Costelas / Tórax / Traumatismo Múltiplo / Acidentes de Trabalho / Acidentes de Trânsito / Tubos Torácicos / Escala de Gravidade do Ferimento Tipo de estudo: Estudo de etiologia / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Idoso / Humanos / Masculino Idioma: Inglês Revista: The Korean Journal of Thoracic and Cardiovascular Surgery Ano de publicação: 2013 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Pneumonia / Pneumotórax / Fraturas das Costelas / Costelas / Tórax / Traumatismo Múltiplo / Acidentes de Trabalho / Acidentes de Trânsito / Tubos Torácicos / Escala de Gravidade do Ferimento Tipo de estudo: Estudo de etiologia / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Idoso / Humanos / Masculino Idioma: Inglês Revista: The Korean Journal of Thoracic and Cardiovascular Surgery Ano de publicação: 2013 Tipo de documento: Artigo