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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 2/2023

Open Access 17-12-2022 | Central Nervous System Trauma | Original Article

Comorbidities, injury severity and complications predict mortality in thoracic trauma

Authors: Anne T. Fokkema, Bergros K. Johannesdottir, Klaus Wendt, Rune Haaverstad, Inge H. F. Reininga, Thomas Geisner

Published in: European Journal of Trauma and Emergency Surgery | Issue 2/2023

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Abstract

Purpose

Thoracic trauma accounts for 25–50% of posttraumatic mortality. Data on epidemiology of thoracic trauma in Scandinavia and risk factors for mortality are scarce. This study aims to provide an overview of epidemiology, clinical events and risk factors for mortality of patients with severe thoracic injuries.

Methods

A retrospective study including adult thoracic trauma patients with abbreviated injury scale ≥ 3, between 2009 and 2018 at Haukeland University Hospital was performed. Subgroup analyses were performed for specific patient groups: (1) isolated thoracic trauma, (2) polytrauma without Traumatic Brain Injury (TBI) and (3) polytrauma with TBI. Logistic regression analyses were applied to find risk factors for 30-days mortality. Age, sex, comorbidity polypharmacy score (CPS), trauma and injury severity score (TRISS) and comprehensive complication index (CI) were included in the final model.

Results

Data of 514 patients were analyzed, of which 60 (12%) patients died. Median (IQR) injury severity score (ISS) was 17 (13–27). Data of 463 patients, of which 39 patients died (8%), were included in multivariate analyses. Female sex odds ratio (OR) (2.7, p = 0.04), CPS > 9 (OR 4.8; p = 0.01), TRISS ≤ 50% (OR 44; p < 0.001) and CI ≥ 30 (OR 12.5, p < 0.001) were significant risk factors for mortality. Subgroup analyses did not demonstrate other risk factors.

Conclusion

Comorbidities and associated pharmacotherapies, TRISS, female sex, and complications during admission predict in-hospital mortality after thoracic trauma. Current findings might help to recognize patients at risk of an adverse outcome, and thereby prevent complications.

Trial registration: retrospectively registered

The regional committees for medical and health research ethics file number is 2017/293.
Appendix
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Metadata
Title
Comorbidities, injury severity and complications predict mortality in thoracic trauma
Authors
Anne T. Fokkema
Bergros K. Johannesdottir
Klaus Wendt
Rune Haaverstad
Inge H. F. Reininga
Thomas Geisner
Publication date
17-12-2022
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 2/2023
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-022-02177-6

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