Thorac Cardiovasc Surg
DOI: 10.1055/s-0039-1700505
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Lung Contusion in Polytrauma: An Analysis of the TraumaRegister DGU

1  Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Erlangen, Germany
2  Department of Trauma and Orthopedic Surgery, BG Hospital Unfallkrankenhaus Berlin GmbH, Berlin, Germany
,
Rebekka Finkbeiner
1  Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Erlangen, Germany
,
Rolf Lefering
3  IFOM, Institute for Research in Operative Medicine, Faculty of Health, University Witten/Herdecke, Ostmerheimer Straße 200, 51109, Cologne, Germany
,
Marco Grosso
1  Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Erlangen, Germany
,
Sebastian Krinner
1  Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Erlangen, Germany
,
Andreas Langenbach
1  Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Erlangen, Germany
,
the TraumaRegister DGU
4  Committee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS) of the German Trauma Society (DGU)
› Author Affiliations
Further Information

Publication History

26 November 2018

02 September 2019

Publication Date:
13 December 2019 (online)

Abstract

Background Thorax trauma frequently occurs in which injuries to the bony chest, lung contusions (LCs), and others are diagnosed. The significance of this violation is described very differently and is mostly based on monocentric data.

Methods A retrospective analysis of the TraumaRegister DGU® (TR-DGU) dataset (Project 2014–062) was performed between 2009 and 2014 (injury severity score [ISS] ≥ 16, primary admission to a trauma center, no isolated traumatic brain injury). Patients with LC (Abbreviated Injury Scale [AIS] 3 + 4) were compared with the control group, and an analysis of different age groups was performed.

Results A total of 49,567 patients were included, thereunder 14,521 (29.3%) without relevant thoracic trauma (TT); 95.9% blunt traumas. 18,892 patients (38.1%) had LC and 14,008 (28.3%) had severe LC with AIS 3 + 4; thereunder 72.7% males. For severe LC, the average age was the lowest (44.7 ± 19.7 years) and ISS the highest (30.4 ± 12.1 points).

Intubation, intensive care, (multi-) organ failure, sepsis, and extrathoracic injuries were most common in severe LC. Shock, chest tubes, further thoracic injuries, and patient death occurred most frequently in TT without LC.

Younger patients showed a higher incidence of LC than the older ones; however, high patient age was a highly significant risk factor for the development of complications and poor outcome.

Conclusion Since LC was present in almost 40% of the severely injured and was related to higher morbidity, LC should be detected and managed at the earliest possible time. Proper follow-ups employing chest X-rays and computed tomography (CT) scans are recommended.