The Success Rate of Emergency Department Thoracotomy for Emergency Penetrating Chest Trauma

Trauma is considered one of the causes of mortality worldwide, among which chest injury is responsible for most of these deaths. This study aims to investigate the success rate of emergency thoracotomy in penetrating chest trauma in the emergency department of Shahid Beheshti and Farghani Hospital.

This study was conducted retrospectively by reviewing the files of patients with penetrating trauma from 2011 to 2021. The inclusion criteria comprised all cases that underwent emergency thoracotomy with chest trauma. Meanwhile, the exclusion criteria were incomplete cases and cases that underwent thoracotomy for other reasons (such as non-emergency thoracotomy, open heart operation, or non-traumatic thoracotomy). In addition, the files of other patients who had underlying diseases, such as cardiovascular diseases were excluded from the study. The study variables, including age, gender, mechanism of trauma, the severity of the trauma, area of ​​trauma, vital signs on arrival, time to reach the operating room, and death or survival of patients were extracted from patient files and entered into the SPSS software, version 22. Finally, the data were analyzed by the Chi-square test and the paired t-tests. The significance level for all tests was considered 0.5.

The average age of the patients was 32.67±13.16 years and 50(34.7%) patients were female while 94(65.3%) patients were male. A total of 91(63.2%) patients died and 53(36.8%) patients survived. The average time from injury to thoracotomy in the emergency department was 20.4±8.9 minutes. Thoracotomy was successful in 19(13.2%) women and 94 (65.3%) men. No significant correlation was found between gender (P=0.82), the mechanism of injury (P=0.58), the severity of injury (P=0.27), and the location of injury (P=0.15). The referral method of patients with successful thoracotomy was not found (P=0.39). The average duration of patients reaching the hospital until thoracotomy was performed in the emergency department was 17.5±6.69 minutes among the patients who survived and 22.14±9.6 among the patients who died. A significant correlation was found between the time from the injury and thoracotomy and the success of thoracotomy in patients (P=0.03).

Finally, the results showed as the average time between injury and thoracotomy gets shorter, the chance of success in thoracotomy increases.