TY - JOUR
T1 - In-Hospital Predictors of Need for Ventilatory Support and Mortality in Chest Trauma
T2 - A Multicenter Retrospective Study
AU - Reitano, Elisa
AU - Gavelli, Francesco
AU - Iannantuoni, Giacomo
AU - Fattori, Silvia
AU - Airoldi, Chiara
AU - Matranga, Simone
AU - Cioffi, Stefano Piero Bernardo
AU - Ingala, Silvia
AU - Virdis, Francesco
AU - Rizzo, Martina
AU - Marcomini, Nicole
AU - Motta, Alberto
AU - Spota, Andrea
AU - Maestrone, Matteo
AU - Ragozzino, Roberta
AU - Altomare, Michele
AU - Castello, Luigi Mario
AU - Della Corte, Francesco
AU - Vaschetto, Rosanna
AU - Avanzi, Gian Carlo
AU - Chiara, Osvaldo
AU - Cimbanassi, Stefania
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/1
Y1 - 2023/1
N2 - Chest trauma management often requires the use of invasive and non-invasive ventilation. To date, only a few studies investigated the predictors of the need for ventilatory support. Data on 1080 patients with chest trauma managed in two different centers were retrospectively analyzed. Univariate and multivariate analyses were performed to identify the predictors of tracheal intubation (TI), non-invasive mechanical ventilation (NIMV), and mortality. Rib fractures (p = 0.0001) fracture of the scapula, clavicle, or sternum (p = 0.045), hemothorax (p = 0.0035) pulmonary contusion (p = 0.0241), and a high Injury Severity Score (ISS) (p ≤ 0001) emerged as independent predictors of the need of TI. Rib fractures (p = 0.0009) hemothorax (p = 0.0027), pulmonary contusion (p = 0.0160) and a high ISS (p = 0.0001) were independent predictors of NIMV. The center of trauma care (p = 0.0279), age (p < 0.0001) peripheral oxygen saturation in the emergency department (p = 0.0010), ISS (p < 0.0001), and Revised Trauma Score (RTS) (p < 0.0001) were independent predictors of outcome. In conclusion, patients who do not require TI, while mandating ventilatory support with selected types of injuries and severity scores, are more likely to be subjected to NIMV. Trauma team expertise and the level of the trauma center could influence patient outcomes.
AB - Chest trauma management often requires the use of invasive and non-invasive ventilation. To date, only a few studies investigated the predictors of the need for ventilatory support. Data on 1080 patients with chest trauma managed in two different centers were retrospectively analyzed. Univariate and multivariate analyses were performed to identify the predictors of tracheal intubation (TI), non-invasive mechanical ventilation (NIMV), and mortality. Rib fractures (p = 0.0001) fracture of the scapula, clavicle, or sternum (p = 0.045), hemothorax (p = 0.0035) pulmonary contusion (p = 0.0241), and a high Injury Severity Score (ISS) (p ≤ 0001) emerged as independent predictors of the need of TI. Rib fractures (p = 0.0009) hemothorax (p = 0.0027), pulmonary contusion (p = 0.0160) and a high ISS (p = 0.0001) were independent predictors of NIMV. The center of trauma care (p = 0.0279), age (p < 0.0001) peripheral oxygen saturation in the emergency department (p = 0.0010), ISS (p < 0.0001), and Revised Trauma Score (RTS) (p < 0.0001) were independent predictors of outcome. In conclusion, patients who do not require TI, while mandating ventilatory support with selected types of injuries and severity scores, are more likely to be subjected to NIMV. Trauma team expertise and the level of the trauma center could influence patient outcomes.
KW - chest trauma
KW - emergency medicine
KW - emergency surgery
KW - trauma
UR - http://www.scopus.com/inward/record.url?scp=85146744777&partnerID=8YFLogxK
U2 - 10.3390/jcm12020714
DO - 10.3390/jcm12020714
M3 - Article
SN - 2077-0383
VL - 12
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 2
M1 - 714
ER -