Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 7 Issue 9

The Factors that Determine the Mortality in Chest Trauma, and in the Determination of Mortality, Comparision of Sufficiency of Injury Severity Score and New Injury Severity Score

Mehmet Özgel*

Department of Thoracic Surgery, Malatya Turgut Özal University School of Medicine, Türkiye

*Corresponding Author: Mehmet Özgel, Department of Thoracic Surgery, Malatya Turgut Özal University School of Medicine, Türkiye.

Received: July 03, 2023; Published: August 24, 2023

Abstract

Background:Localized thorax and generalized body trauma can be turned into a potentially life-threatening situation for the patients.

Aim: Specific numerical values can be given to the data obtained by close follow-up of the changes in the clinical status of the trauma patient. In this way, the necessary approach or transfer process can be previously predicted to reduce the patients' mortality and morbidity.

Methods: Four hundred fourteen patients were inspected due to thorax trauma and hospitalized for six years. In our hospital was used therapy of patients. Those patients were divided into three groups retrospectively. They were classified as Group I (n = 64) patients with blunt trauma but without rib fracture, group II patients (n = 220) with blunt trauma and rib fracture, and group III patients (n = 130) with penetrating injury. The relation between the mortality and Injury Severity Score (ISS), New Injury Severity Score (NISS), and age were analyzed in these three groups. I used ROC and χ2 test for statistical evaluation in the SPSS program. If the results were p < 0.05, I accepted the value as significant.

Results: For this patients it’s found that 68 % (n = 284) hospitalized for blunt thorax trauma, 32 % (n = 130) penetrating trauma. Also, 55% (n = 156) of the blunt trauma group were in the vehicle unit, 23% (n = 65) of their cars crashed, and 22% (n = 63) of them were observed to fall. After the penetrating injury, tube thoracostomy was applied to 77.2 % (n = 78) of patients with hemopneumothorax. After blunt trauma, tube thoracostomy was applied to 79,9 % (n = 143) of patients with hemopneumothorax. 8.9% (n = 16) were operated on after penetrating injury 20,4 % (n = 20) of patients with hemopneumothorax. The ratio of operations applicated in our clinic between Group II-III and Group I-III was significantly longer (p < 0.05).

6,7 % (n = 19) of blunt trauma and 3.1 % (n = 4) penetrating trauma resulted in mortality. For the patients who died in the penetrating trauma group, ISS points were a maximum of 26 points, a minimum of 16 points, and NISS points were a maximum of 35 and minimum of 22 points. Although in the blunt trauma group, ISS points were maximum of 45 points, minimum of 9 points, and NISS points were a maximum of 57 points and minimum of 34 points.

Conclusions: The complexity of trauma and relation with more than one system were significant risk factors for mortality. The mortality risk in chest trauma increased in patients over 45 years old and had ISS or NISS of more than 16 points. According to our statistical results, we found that NISS is more reliable than ISS.>

Keywords: Thoracic Trauma; ISS and NISS; Mortality

References

  1. Liman ŞT., et al. “Chest injury due to blunt trauma”. European Journal of Cardio-Thoracic Surgery 23 (2003): 374-378.
  2. Van Natta TL and Morris JA Jr. “Injury scoring and trauma outcomes. In Mattox KL, Feliciano DV, Moore EE. (ed): Trauma”. McGraw Hill Companies (2000): 69-80.
  3. Harwood PJ., et al. “Which AIS based scoring system is the best predictor of outcome in orthopaedic blunt trauma patients?” Journal of Trauma - Injury, Infection and Critical Care2 (2006): 334-340.
  4. H Li and YF Ma. “New injury severity score (NISS) outperforms injury severity score (ISS) in the evaluation of severe blunt trauma patients”. Chinese Journal of Traumatology 24 (2021): 261-265.
  5. Stevenson M., et al. “An overview of the injury severity score and the new injury severity score”. Injury Prevention 7 (2001): 10-13.
  6. Osler T., et al. “A Modification of the injury Severity Score that Both Improves Accuracy and Simplifies Scoring”. Journal of Trauma 6 (1997): 922-926.
  7. Voggenreiter G., et al. “Operative chest wall stabilization in flail chest-outcomes of patients with or without pulmonary contusion”. Journal of the American College of Surgeons 187 (1998): 130-138.
  8. Beg M., et al. “Penetran chest trauma: a rewiev of 150 cases”. Journal of Indian Medical Association 87 (1989): 203-205.
  9. Clarc GC., et al. “Variables affecting outcome in blunt chest trauma: Flail chest vs. pulmoner contusion”. Journal of Trauma 28 (1988): 298-304.
  10. Thomas AN., et al. “Operative stabilization for flail chest after blunt trauma”. The Journal of Thoracic and Cardiovascular Surgery 75 (1978): 793-801.
  11. Relihan M and Litwin MS. “Morbidity and mortality associated with flail chest injury: A rewiev 85 cases” Journal of Trauma 13 (1973): 663-671.
  12. Mayberr JC and Trunkey DD. “The fractured rib in chest wall trauma”. Chest Surgery Clinics of North America 2 (1997): 239-261.
  13. Zieger DW and Agarwal NN. “The morbidity and mortality of rib fractures”. Journal of Trauma 6 (1994): 975-979.
  14. Eid HO and Abu-Zidan FM. “New Injury Severity Score is a better predictor of mortality for blunt trauma patients than the Injury Severity Score”. World Journal of Surgery 39 (2015): 165-171.
  15. Sullivan T., et al. “Prediction of mortality in pediatric trauma patients: new injury severity score outperforms injury severity score in the severely injured”. Journal of Trauma 55 (2003): 1083-1088.
  16. Smith BP., et al. “A comparison of injury severity score and new injury severity score after penetrating trauma: a prospective analysis”. Journal of Trauma and Acute Care Surgery 79 (2015): 269-274.
  17. Brenneman FD., et al. “Measuring injury severity: time for a change?” Journal of Trauma 44 (1998): 580-582.
  18. Balogh Z., et al. “NISS predicts post-injury multiple organ failure beter than the ISS”. Journal of Trauma 48 (2008): 624-628.
  19. Tamim H., et al. “The injury severity score or the new injury severity score for predicting mortality, intensive care unit admission and length of hospital stay: experience from a university hospital in a developing country”. Injury 39 (2008): 115-120.

Citation

Citation: Mehmet Özgel. “The Factors that Determine the Mortality in Chest Trauma, and in the Determination of Mortality, Comparision of Sufficiency of Injury Severity Score and New Injury Severity Score”.Acta Scientific Medical Sciences 7.9 (2023): 151-158.

Copyright

Copyright: © 2023 Mehmet Özgel. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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