The Outcomes of Chest Wall Stabilization in Flail Chest Patients in the Intensive Care Unit

Objectives: In this study, the effect of multi-trauma on treatment results in flail chest patients who underwent chest wall stabilization was investigated.
Methods: The data of thirty-six flail chest cases between the ages of 18–79 who were consulted for thoracic surgery were retrospectively analyzed in the study. The presence of flail chest in the patients was confirmed by thoracic surgeons, and the multi-traumas were confirmed through the diagnoses made by specialist physicians reexamining clinical methods.
Results: It was found that 27 (75%) of flail chest cases evaluated had multi-trauma, and 3 (8.3%) of the cases had mortality in the study. It was found that the duration of the intensive care unit stay and the number of days on invasive mechanical ventilation of the cases were positively correlated with the number of surgical areas exposed to trauma (p<0.05). According to the univariate binary logistic regression analysis, it was found that the total number of rib fractures (OR = 1.44, p=0.055), the number of fixed ribs (OR = 0.76, p=0.558), the number of plates placed for fixation (OR = 0.70, p=0.368), and the number of additional trauma areas outside the thorax (OR = 6.76, p=0.076) were not statistically significant in increasing the mortality risk.
Conclusion: Considering that multi-trauma is an effective factor in the prolongation of the duration of treatment, the management of traumas with different specialties can positively affect the treatment results and reduce the risk of mortality.

Yoðun Bakim Ünitesindeki Hastalarda Yelken Göðüs Nedeniyle Göðüs Duvari Stabilizasyonunun Sonuçlarý

Araç: Bu araþtýrmada göðüs duvarý stabilizasyonu yapýlan yelken göðüs hastalarýnda multitravma varlýðýnýn tedavi sonuçlarýna ve mortaliteye etkisi incelenmiþtir.
Yöntem: Araþtýrmada gögüs cerrahisine konsülte edilen 18-79 yaþ aralýðýndaki 36 yelken göðüs vakasýnýn verisi geriye dönük olarak incelendi. Hastalardaki yelken göðüs varlýðý göðüs cerrahi uzmanlarýnca konulan, multitravmalarý ise alanýnda uzman hekimler tarafýndan konulan tanýlar aracýlýðýyla (rutin kan tahlili, direkt X-ray radyografi bulgularý, ultrason sonuçlarý, bilgisayarlý tomografi ve MR) doðrulandý.
Bulgular: Araþtýrmada deðerlendirilen yelken göðüs vakalarýnýn 27’sinde (%75) mutitravma ve vakalarýn 3'ünde (%8,3) mortalite olduðu bulundu. Moratlite olan vakalarýn tamamýnda erkek cinsiyet, oral trakeal entübasyon ve invaziv mekanik ventilasyon ihtiyacý, pulmoner kontüzyon, hemopnönomotoraks, kafa travmasý ve omurilik travmasý olduðu bulundu. Vakalarýn yoðun bakýmda kalma ve invasive invaziv mekanik ventilasyonda kalma sürelerinin travmaya maruz kalan cerrahi bölge sayýlarýyla pozitif iliþkili olduðu (p<0,05) bulundu. Tek Deðiþkenli Binary Lojistik Regresyon Analizine göre toplam kaburga kýrýðý sayýsýnýn (OR=1,44 %95 CI: 0,99-2,09, p=0,055), fikse edilen kaburga sayýsýnýn (OR=0,76; %95 CI: 0,35-1,77, p=0,558), fiksasyon için konulan plak sayýsýnýn (OR=0,70; %95 CI: 0,32 1,52, p=0,368) ve toraks dýþý ek travma sayýsýnýn (OR=6,76; %95 CI: 0,82-55,93, p=0,076) mortalite riskini artýrmada istatistiksel açýdan anlamlý derecede etkili olmadýðý bulundu.
Sonuç: Yelken göðüs vakalarýnda multitravmalar göreceli olarak mortalite riskini artýrsa da bu risk artýþýnýn istatistiksel açýdan anlamlý deðildir. Multitravmalarýn tedavi sürelerinin uzamasýnda etkili bir faktör olduðu düþünüldüðünde farklý uzmanlýk alanlarýyla travmalarýn yönetilmesi mortalite riskini azaltabilir. (SETB-2021-03-066)