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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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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
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author 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
author_facet 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
author_sort Reitano, Elisa
collection PubMed
description 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.
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spelling pubmed-98630242023-01-22 In-Hospital Predictors of Need for Ventilatory Support and Mortality in Chest Trauma: A Multicenter Retrospective Study 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 J Clin Med Article 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. MDPI 2023-01-16 /pmc/articles/PMC9863024/ /pubmed/36675639 http://dx.doi.org/10.3390/jcm12020714 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
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
In-Hospital Predictors of Need for Ventilatory Support and Mortality in Chest Trauma: A Multicenter Retrospective Study
title In-Hospital Predictors of Need for Ventilatory Support and Mortality in Chest Trauma: A Multicenter Retrospective Study
title_full In-Hospital Predictors of Need for Ventilatory Support and Mortality in Chest Trauma: A Multicenter Retrospective Study
title_fullStr In-Hospital Predictors of Need for Ventilatory Support and Mortality in Chest Trauma: A Multicenter Retrospective Study
title_full_unstemmed In-Hospital Predictors of Need for Ventilatory Support and Mortality in Chest Trauma: A Multicenter Retrospective Study
title_short In-Hospital Predictors of Need for Ventilatory Support and Mortality in Chest Trauma: A Multicenter Retrospective Study
title_sort in-hospital predictors of need for ventilatory support and mortality in chest trauma: a multicenter retrospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9863024/
https://www.ncbi.nlm.nih.gov/pubmed/36675639
http://dx.doi.org/10.3390/jcm12020714
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