The role of trauma scoring systems and serum lactate level in predicting prognosis in thoracic trauma.

BACKGROUND: Chest trauma constitutes 10% of admissions due to trauma and causes 25-50% of trauma-related deaths. It is important to evaluate the level of thoracic trauma in patients accurately and early, start the correct treatment, predict the need for intensive care and mortality, and prevent complications that may develop. In this study, the predictive efficiency of the serum lactate level, shock index, and scoring systems regarding the prognosis in patients with major thoracic trauma were compared. METHODS: The files of the 683 patients who applied to the emergency department of our hospital due to trauma, between 2014 and 2020, were analyzed retrospectively. Patients with isolated thoracic trauma were included in the study. RESULTS: A total of 683 patients were included in the study. Of the patients, 34 (5%) were in the non-survivor group and 649 (95%) were in the survivor group. There was no statistically significant difference between the systolic blood pressure, diastolic blood pressure, pulse rate, respiratory rate, or shock index in either group (p>0.05). The Glasgow Come Scale (GCS) score in the non-survivor group was significantly lower than that in the survivor group (p=0.000). The lactate level, revised trauma score (RTS), injury severity score (ISS), and New ISS (NISS) in the non-survivor group were significantly higher than those in the survivor group. A significant difference was found in terms of age, lactate level, and the GCS, RTS, ISS, and NISS (p<0.05). In logistic regression analysis, it was found that a 1 unit increase in the lactate value increased the mortality rate by 1.19 times in terms of the effect of the trauma scores and numerical change in the lactate level on mortality. CONCLUSION: In patients with thoracic trauma, the NISS may be a useful factor that can be used in emergency rooms when a quick decision is required. However, increases in blood lactate levels during patient follow-up may also be a blood parameter that the clinician should pay attention to. In addition, further studies should be conducted on scoring in patients with thoracic trauma.

Local treatment of pain in Tietze syndrome: A single-center experience.

BACKGROUND: In this study, we present our experiences with local injections of triamcinolone and prilocaine in patients diagnosed with Tietze syndrome. METHODS: Between January 2016 and January 2019, a total of 28 patients (12 males, 16 females; median age: 33 years; range, 21 to 51 years) who were diagnosed with TS in our clinic were retrospectively analyzed. Triamcinolone hexacetonide and prilocaine hydrochloride were injected into painful joints. At first week, pain sensation of the patients was recorded using the Pain Rating Scale developed by the British Pain Society. Pain was also assessed at one, two, and three weeks after injections qualitatively and based on physical examination. RESULTS: At one week, the pain severity before the local injection treatment was above average the pain-related discomfort rates, and the response was quite favorable after the treatment (p=0.005 and p=0.001, respectively). A statistically significant rating was observed for treatment response and success (p=0.003). Totally 75% of the patients experienced more than 70% reduction in pain level after the injection. CONCLUSION: Our treatment approach involving injection of a mixture of steroid and a local anesthetic provides a rapid relief from pain, irrespective of age, sex, or employment status in patients diagnosed with Tietze syndrome.