Long-term outcome in chest trauma

Anesthesiology. 2008 Nov;109(5):864-71. doi: 10.1097/ALN.0b013e31818a4009.

Abstract

Background: Currently, there are limited data available describing the long-term outcomes of chest trauma survivors. Here, the authors sought to describe chest trauma survivor outcomes 6 months and 1 yr after discharge from the intensive care unit, paying special attention to pulmonary outcomes.

Methods: A cohort of 105 multiple trauma patients with blunt chest trauma admitted to the intensive care unit was longitudinally evaluated. After 6 months, a chest computed tomography scan, pulmonary function testing (PFT), and quality of life were collected in 55 of these patients. A subgroup of 38 patients was followed up for 1 yr.

Results: At least one abnormal PFT result was found in 39 patients (71%). Compared with normalized data of the age- and sex-matched population, physical function was decreased in 38 patients (70%). The 6-min walk distance was reduced for 29 patients (72%). Although pathologic images were observed on the chest computed tomography scan from 33 patients (60%), no relation was found between PFT and computed tomography. A ratio of arterial oxygen pressure to inspired oxygen fraction less than 200 at admission to the intensive care unit predicted an abnormal PFT result at 6 months. One year after discharge from the intensive care unit, paired comparisons showed a significant increase in forced vital capacity (P = 0.02) and Karnofsky Performance Status (P < 0.001).

Conclusions: Survivors of multiple traumas including chest trauma demonstrate a persistent decrease in the 6-min walk distance, impairment on PFT, and reduced pulmonary-specific quality of life.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Multiple Trauma / complications*
  • Multiple Trauma / physiopathology*
  • Multiple Trauma / psychology
  • Prospective Studies
  • Quality of Life / psychology
  • Respiratory Function Tests / trends
  • Thoracic Injuries / complications*
  • Thoracic Injuries / physiopathology*
  • Thoracic Injuries / psychology
  • Time
  • Trauma Severity Indices
  • Treatment Outcome