Department of Trauma Surgery, Regional Trauma Center, Gachon University Gil Hospital, Incheon, Korea
Copyright © 2017 The Korean Society of Trauma
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PCPR: prehospital cardiopulmonary resuscitation, F to TB (min): field to trauma bay (minutes), ISS: Injury severity score, RTS: revised trauma score, TRISS: trauma and injury severity score, AIS: abbreviated Injury scale, GCS: Glascow coma scale, SBP: systemic blood pressure at trauma bay, EDT: emergency department thoracotomy, CT: computed tomography, N: no, TA: traffic accident, Y: yes, IVC: inferior vena cava.
Case | Time TB to OR (min) | Time F to OR (min) | Incision | Cardiac repair | Concomitant procedure | OP time (min) | Ventilator (days) | ICU stay (days) | Post OP echo finding | Outcome | Cause of death |
---|---|---|---|---|---|---|---|---|---|---|---|
1 | 84 | 150 | Median sternotomy | Right ventricle | Pulmonary repair: left upper lobe | 140 | 1 | 5 | RWMA at LAD territory, depressed LV systolic function (EF: 47%) | 2nd OP discharge | |
2 | 37 | 110 | Median sternotomy | Right ventricle | Laparotomy (liver, omental laceration) | 145 | 1 | 5 | Discharge | ||
3 | 33 | 150 | Median sternotomy | Right ventricle | 205 | 0 | 2 | Normal | Discharge | ||
4 | 59 | 195 | Median sternotomy | Right ventricle | 110 | 0 | 0a | Transfer | |||
5 | 38 | 75 | Median sternotomy | Right ventricle | LIMA ligation | 105 | 0 | 3 | Normal | Discharge | |
6 | 70 | 235 | Median sternotomy | Left atrium | 180 | 5 | 8 | Postoperative constrictive physiology, reduced LV systolic function(EF:35~45), moderate global hypokinesia | Transfer | ||
7 | 64 | 120 | EDT | Right ventricle | Pulmonary repair: left upper lobe, Laparotomy (colon laceration) | 230 | 0 | 0a | Expire | DIC | |
8 | 117 | 142 | Median sternotomy | Right atrium | 135 | 1 | 3 | Normal | Discharge | ||
9 | 67 | 241 | Median sternotomy | Pericardium | 130 | 1 | 2 | Normal | Discharge | ||
10 | 47 | 80 | EDT, clamshell | Right ventricle | Pulmonary repair: right lower lobe Laparotomy (IVC laceration) | 185 | 0 | 1 | Expire | Hemorrhagic shock | |
11 | 74 | 460 | Median sternotomy | Pericardium | 130 | 10 | 18 | Normal | Transfer | ||
12 | 113 | 213 | Left anterior thoracotomy | Pericardium | 75 | 0 | 2 | Normal | Discharge | ||
13 | 59 | 120 | Median sternotomy | Right ventricle | 170 | 0 | 1 | Normal | Transfer | ||
14 | 65 | 110 | Median sternotomy | Right atrium | 135 | 0 | 3 | Transfer | |||
15 | 49 | 80 | Median sternotomy | Right atrium | 105 | 1 | 2 | Discharge | |||
16 | 35 | 146 | EDT, Median sternotomy | Right ventricle | Peritoneal pelvic packing | 182 | 0 | 0a | Expire | Cardiac tamponade | |
17 | 46 | 75 | EDT, clamshell | Right ventricle | Wedge resection: left upper lobe, primary repair: right upper lobe | 167 | 1 | 1 | Expire | Hemorrhagic shock | |
18 | 81 | 135 | Left thoracotomy | Right ventricle | Pulmonary repair: left upper lobe, left arm repair | 210 | 0 | 2 | Discharge |
TB to OR (min): field to operation room (minutes), F to OR (min): field to operation room (minutes), OP: operation, ICU: intensive care unit, RWMA: regional wall motion abnormality, LAD: left anterior descending coronary artery, LV: left ventricle, EF: ejection fraction, LIMA: left internal mammary artery, EDT: emergency department thoracotomy, DIC: disseminated intravascular coagulation, IVC: inferior vena cava.
aExpired on admission day.
CPR: cardiopulmonary resuscitation, ISS: injury severity scale, RTS: revised trauma score, TRISS: trauma and injury severity score, AIS: abbreviated Injury scale, GCS: Glascow coma scale, ISBP: initial systolic blood pressure, TB: trauma bay, EDT: emergency department thoracotomy, F to TB (min): field to trauma bay (minutes), TB to OR: trauma bay to operation room, F to OR: field to operation room, OP: operation.
Case | Sex | Age (years) | Mechanism | Severity of trauma | PCPR | Time F to TB (min) | Consciousness | ISS | RTS | TRISS | AIS chest | GCS | SBP (mmHg) | EDT | CT |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | M | 36 | Stab injury | Cardiac tamponade, tension hemopneumothorax | N | 66 | Verbal | 10 | 7.108 | 89.1 | 5 | 14 | 80 | N | N |
2 | M | 63 | Stab injury | Cardiac tamponade, liver laceration | N | 73 | Painful | 26 | 6.904 | 67.1 | 5 | 9 | 112 | N | N |
3 | F | 32 | Stab injury | Cardiac tamponade | N | 117 | Painful | 26 | 6.904 | 93.3 | 5 | 9 | 122 | N | Outside |
4 | F | 40 | Stab injury | Hemopericardium | N | 136 | Alert | 34 | 7.841 | 99.0 | 3 | 15 | 93 | N | N |
5 | M | 54 | Stab injury | Cardiac tamponade | N | 37 | Verbal | 38 | 5.439 | 76.4 | 5 | 12 | 50 | N | N |
6 | M | 64 | Occupant TA | Massive hemothorax right, cardiac tamponade | N | 165 | Painful | 24 | 5.235 | 46.7 | 5 | 7 | 86 | N | Outside |
7 | M | 30 | Stab injury | Cardiac arrest | Y | 56 | unresponse | 34 | 0 | 0.8 | 5 | 7 | 0 | Y | N |
8 | F | 25 | Pedestrian TA | Cardiac tamponade | N | 25 | Painful | 20 | 3.479 | 30.8 | 5 | 7 | 49 | Pericardiocentesis | Y |
9 | M | 60 | Occupant TA | Cardiac tamponade | N | 180 | Verbal | 10 | 7.841 | 89.5 | 4 | 15 | 130 | N | Y |
10 | F | 36 | Stab injury | Cardiac arrest, IVC laceration, liver laceration | Y | 33 | Unresponse | 26 | 3.600 | 0.9 | 5 | 3 | 0 | Y | N |
11 | M | 51 | Occupant TA | Hemopericardium, hemothorax, multiple rib fracture | N | 386 | Painful | 26 | 3.565 | 68.2 | 4 | 5 | 64 | N | Y |
12 | M | 19 | Stab injury | Hemopericardium | N | 100 | Alert | 9 | 7.841 | 99.1 | 3 | 15 | 108 | N | Y |
13 | F | 59 | Stab injury | Hemopericardium | N | 61 | Alert | 27 | 7.550 | 88.8 | 5 | 15 | 101 | N | Outside |
14 | M | 50 | Pedestrian TA | Hemopericardium | N | 45 | Verbal | 33 | 6.376 | 83.9 | 5 | 14 | 65 | N | Y |
15 | M | 50 | Occupant TA | Hemopericardium | N | 31 | Painful | 29 | 5.676 | 77.1 | 5 | 7 | 103 | N | Y |
16 | M | 47 | Pedestrian TA | Cardiac tamponade, cardiac arrest | Y | 111 | Unresponse | 75 | 1.163 | 0.3 | 6 | 3 | 0 | N | N |
17 | M | 45 | Stab injury | Right ventricle perforation, left upper lobe perforation | Y | 29 | Unresponse | 25 | 0 | 1.5 | 5 | 3 | 0 | Y | N |
18 | M | 47 | Stab injury | Hemothorax left, left lung injury | N | 54 | Alert | 10 | 7.841 | 99.0 | 3 | 15 | 139 | N | Y |
Case | Time TB to OR (min) | Time F to OR (min) | Incision | Cardiac repair | Concomitant procedure | OP time (min) | Ventilator (days) | ICU stay (days) | Post OP echo finding | Outcome | Cause of death |
---|---|---|---|---|---|---|---|---|---|---|---|
1 | 84 | 150 | Median sternotomy | Right ventricle | Pulmonary repair: left upper lobe | 140 | 1 | 5 | RWMA at LAD territory, depressed LV systolic function (EF: 47%) | 2nd OP discharge | |
2 | 37 | 110 | Median sternotomy | Right ventricle | Laparotomy (liver, omental laceration) | 145 | 1 | 5 | Discharge | ||
3 | 33 | 150 | Median sternotomy | Right ventricle | 205 | 0 | 2 | Normal | Discharge | ||
4 | 59 | 195 | Median sternotomy | Right ventricle | 110 | 0 | 0 |
Transfer | |||
5 | 38 | 75 | Median sternotomy | Right ventricle | LIMA ligation | 105 | 0 | 3 | Normal | Discharge | |
6 | 70 | 235 | Median sternotomy | Left atrium | 180 | 5 | 8 | Postoperative constrictive physiology, reduced LV systolic function(EF:35~45), moderate global hypokinesia | Transfer | ||
7 | 64 | 120 | EDT | Right ventricle | Pulmonary repair: left upper lobe, Laparotomy (colon laceration) | 230 | 0 | 0 |
Expire | DIC | |
8 | 117 | 142 | Median sternotomy | Right atrium | 135 | 1 | 3 | Normal | Discharge | ||
9 | 67 | 241 | Median sternotomy | Pericardium | 130 | 1 | 2 | Normal | Discharge | ||
10 | 47 | 80 | EDT, clamshell | Right ventricle | Pulmonary repair: right lower lobe Laparotomy (IVC laceration) | 185 | 0 | 1 | Expire | Hemorrhagic shock | |
11 | 74 | 460 | Median sternotomy | Pericardium | 130 | 10 | 18 | Normal | Transfer | ||
12 | 113 | 213 | Left anterior thoracotomy | Pericardium | 75 | 0 | 2 | Normal | Discharge | ||
13 | 59 | 120 | Median sternotomy | Right ventricle | 170 | 0 | 1 | Normal | Transfer | ||
14 | 65 | 110 | Median sternotomy | Right atrium | 135 | 0 | 3 | Transfer | |||
15 | 49 | 80 | Median sternotomy | Right atrium | 105 | 1 | 2 | Discharge | |||
16 | 35 | 146 | EDT, Median sternotomy | Right ventricle | Peritoneal pelvic packing | 182 | 0 | 0 |
Expire | Cardiac tamponade | |
17 | 46 | 75 | EDT, clamshell | Right ventricle | Wedge resection: left upper lobe, primary repair: right upper lobe | 167 | 1 | 1 | Expire | Hemorrhagic shock | |
18 | 81 | 135 | Left thoracotomy | Right ventricle | Pulmonary repair: left upper lobe, left arm repair | 210 | 0 | 2 | Discharge |
Variables | Total (n=18, 100%) | Survival (n=14, 77.778%) | Fatality (n=4, 22.222%) | p-value |
---|---|---|---|---|
Sex | 1.000 | |||
Male | 13 (72.2%) | 10 (71.4%) | 3 (75.0%) | |
Female | 5 (27.8%) | 4 (28.6%) | 1 (25.0%) | |
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Age (years) | 47.0 (35.0, 55.3) | 50.0 (35.0, 59.3) | 40.5 (31.6, 46.5) | 0.202 |
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Mechanism | 1.000 | |||
Blunt | 7 (38.9%) | 6 (42.9%) | 1 (25.0%) | |
Penetrating | 11 (61.1%) | 8 (57.1%) | 3 (75.0%) | |
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Prehospital CPR | 4 (22.2%) | 0 | 4 (100%) | <0.001 |
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ISS | 26.00 (17.50, 33.25) | 26.00 (10.00, 30.00) | 30.00 (25.25, 64.75) | 0.199 |
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RTS | 6.026 (3.544, 7.623) | 6.904 (5.389, 7.841) | 0.582(0, 2.991) | 0.005 |
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TRISS | 76.750 (23.475, 90.450) | 86.350 (67.925, 94.725) | 0.850 (0.425, 1.350) | 0.003 |
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AIS chest | 5.00 (4.00, 5.00) | 5.00 (3.75, 5.00) | 5.00 (5.00, 5.75) | 0.066 |
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GCS | 9.0 (6.5, 15.0) | 13.0 (7.0, 15.0) | 3.0 (3.0, 6.0) | 0.006 |
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ISBP at TB (mmHg) | 83.00 (36.75, 109.00) | 97.00 (64.75, 114.50) | 0 | 0.003 |
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EDT | 4 (22.2%) | 0 | 4 (100%) | <0.001 |
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Pericardiocentesis | 1 (5.6%) | 1 (7.1%) | 0 | 1.000 |
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Time F to TB (min) | 63.50 (36.00, 121.75) | 69.50 (43.00, 143.25) | 44.50 (30.00, 97.25) | 0.243 |
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Time TB to OR (min) | 61.50 (44.00, 75.75) | 66.00 (46.25, 81.75) | 46.50 (37.75, 59.75) | 0.111 |
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Time F to OR (min) | 138.50 (102.50, 199.50) | 146.00 (110.00, 218.50) | 100.00 (76.25, 139.50) | 0.123 |
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OP time (min) | 142.50 (125.00, 182.75) | 135.00 (108.75, 172.50) | 183.50 (170.75, 218.75) | 0.033 |
PCPR: prehospital cardiopulmonary resuscitation, F to TB (min): field to trauma bay (minutes), ISS: Injury severity score, RTS: revised trauma score, TRISS: trauma and injury severity score, AIS: abbreviated Injury scale, GCS: Glascow coma scale, SBP: systemic blood pressure at trauma bay, EDT: emergency department thoracotomy, CT: computed tomography, N: no, TA: traffic accident, Y: yes, IVC: inferior vena cava.
TB to OR (min): field to operation room (minutes), F to OR (min): field to operation room (minutes), OP: operation, ICU: intensive care unit, RWMA: regional wall motion abnormality, LAD: left anterior descending coronary artery, LV: left ventricle, EF: ejection fraction, LIMA: left internal mammary artery, EDT: emergency department thoracotomy, DIC: disseminated intravascular coagulation, IVC: inferior vena cava. Expired on admission day.
CPR: cardiopulmonary resuscitation, ISS: injury severity scale, RTS: revised trauma score, TRISS: trauma and injury severity score, AIS: abbreviated Injury scale, GCS: Glascow coma scale, ISBP: initial systolic blood pressure, TB: trauma bay, EDT: emergency department thoracotomy, F to TB (min): field to trauma bay (minutes), TB to OR: trauma bay to operation room, F to OR: field to operation room, OP: operation.