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In-Hospital Predictors of Need for Ventilatory Support and Mortality in Chest Trauma: A Multicenter Retrospective Study

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...

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Detalles Bibliográficos
Autores principales: Reitano, Elisa, Gavelli, Francesco, Iannantuoni, Giacomo, Fattori, Silvia, Airoldi, Chiara, Matranga, Simone, Cioffi, Stefano Piero Bernardo, Ingala, Silvia, Virdis, Francesco, Rizzo, Martina, Marcomini, Nicole, Motta, Alberto, Spota, Andrea, Maestrone, Matteo, Ragozzino, Roberta, Altomare, Michele, Castello, Luigi Mario, Della Corte, Francesco, Vaschetto, Rosanna, Avanzi, Gian Carlo, Chiara, Osvaldo, Cimbanassi, Stefania
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9863024/
https://www.ncbi.nlm.nih.gov/pubmed/36675639
http://dx.doi.org/10.3390/jcm12020714
Descripción
Sumario: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.