Publication: Survival outcomes of emergency thoracotomy in severely injured patients performed by a general surgeon at a rural university hospital in Thailand
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Issued Date
2022
Resource Type
Language
eng
File Type
application/pdf
ISSN
19997086
Rights Holder(s)
Scopus
Bibliographic Citation
Journal of Emergency Medicine, Trauma and Acute Care. Vol 2022, No.2 (2022)
Suggested Citation
Tullavardhana T. Survival outcomes of emergency thoracotomy in severely injured patients performed by a general surgeon at a rural university hospital in Thailand. Journal of Emergency Medicine, Trauma and Acute Care. Vol 2022, No.2 (2022). doi:10.5339/jemtac.2022.7 Retrieved from: https://hdl.handle.net/20.500.14740/10264
Author(s)
Abstract
Background: Emergency thoracotomy is a potentially life-saving maneuver for trauma patients in extremis. Since trauma scenarios, in rural locations, usually occur with a high incidence of a severe injury that leads to hemorrhagic shock or cardiopulmonary arrest. The objective of this study was to analyze the experience in emergency thoracotomy performed by a general surgeon in a rural area in Thailand. Methods: This retrospective study was conducted by analyzing the patient records including demographics, mechanisms of injuries, specific organ injury, surgical approach, life-saving surgical procedure, and postoperative outcome for all patients who underwent emergency thoracotomy in the Department of Surgery, Srinakharinwirot University hospital between January 2010 and December 2020. Results: Twelve patients underwent emergency thoracotomy within 1 hour after arrival and were equally divided between blunt and penetrating injuries with 6 (50%). A mean patient age of 34.8 ± 15.2 years (range 16-55), mean systolic blood pressure on arrival was 65.8 ± 35.2 mmHg (range 0-100 mmHg), and the mean injury severity score (ISS) was 54.6 ± 25.2 (range 26-75). Profound hemorrhagic shock is a major indication for emergency thoracotomy. The overall survival rate was 41.7% (5/12 patients) without survivors from cardiac injuries. Four patients (66.7%) in the penetrating and 1 patient (16.7%) in the blunt intrathoracic injury group were survived and discharged from the hospital. Conclusion: Emergency thoracotomy offers a chance for survival at 41.7% for trauma patients who present with extremes in this study. Rapid decision-making, good operative technique, and adequate patient selection are crucial for reasonable outcomes. © 2022 Tullavardhana, licensee HBKU Press.