Journal of Trauma and Injury

  • 제22권2호
  • /
  • Pages.161-166
  • /
  • 2009
  • /
  • 2799-4317(pISSN)
  • /
  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
권호 표지

노인 외상 환자에 대한 분석 및 외상성 혈기흉의 임상양상

Clinical Analysis of Old-aged Chest Trauma Patient and Traumatic Hemopneumothorax

  • 김정태 (성균관 대학교 강북삼성병원 흉부외과)
  • Kim, Jung Tae (Department of Cardiovascular and Thoracic surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 투고 : 2009.07.28
  • 심사 : 2009.10.23
  • 발행 : 2009.12.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study was conducted to analyze chest-trauma patients and the old-aged patients with a traumatic hemopneumothorax. Methods: We reviewed the medical records of 101 chest-trauma patients admitted to the department of cardiovascular and thoracic surgery from June 1999 to November 2008. We evaluated the general characteristics of the chest-trauma patient, especially those of old-aged patients with a traumatic hemopneumothorax. Results: Rib fracture was observed in 99 of the cases, the location distribution was right: left =261: 255, with right being dominant. Rib fractures commonly involved the 4th and the 7th rib. The average number of rib fractures was 5.1, and the average number of rib fractures in the old-aged patients was significantly higher than that in the non-old-aged patients (p=0.04). There were 17 cases of a hemopnuemothorax in old-aged patients, 52 cases in non-old-aged patients. The blood loss through the chest tube for old-aged patients was significantly more than that for the non-old-aged patients, and the initial hemoglobin level was lower in the old-aged patients. Conclusion: Elderly trauma patients are more likely to die after trauma than other age groups. Even with relatively stable vital signs, invasive hemodynamic monitoring and intensive treatment are recommended.

키워드

참고문헌

  1. HC Ahn, JY Seo, JB Chung, YM Choi, JT Choi, KC You, et al. Clinical review in geriatric trauma patients. J Korean Soc Emerg Med 2002;13(1):49-54
  2. Champion HR, Copes WS, Buyer D, Flanagan ME, Bain L, Sacco WJ. Major trauma in geriatric patients. Am J Public Health 1989;79:1278-82 https://doi.org/10.2105/AJPH.79.9.1278
  3. Finelli FC, Jonsson J, Champion HR, Morelli S, Fouty WJ. A case control study for major trauma in geriatric patients. J Trauma 1989;29:541-8 https://doi.org/10.1097/00005373-198905000-00001
  4. Tornetta P 3rd, Mostafavi H, RiinaJ, Turen C, Reimer B, Levine R, et al. Morbidity and Mortality in elderly trauma patients. J Trauma 1999;46:702-6 https://doi.org/10.1097/00005373-199904000-00024
  5. Broos PLO, Stappaerts KH, Rommens PM, Louette LKJ, Gruwez JA. Polytrauma in patients of 65 and over. Injury pattern and outcome. Int Surg 1988;73:119-22
  6. Baker SP, Spitz WV. Age effects and autopsy evidence of disease in fatally injured drivers. JAMA 1970;214:1079-88 https://doi.org/10.1001/jama.214.6.1079
  7. Levy DB, Hanlon DP, Townsend RN. Geriatric trauma. Geriatric Emerg Care 1993;9(3):601-20
  8. Demarest GB, Osler TM, Clevenger FW. Injuries in the elderly: evaluation and initial response. Geriatrics 1990;45:36-40
  9. Wright AS, Schurr MJ. Geriatric trauma: review and recommandations. Wis Med J 2001;100(2):57-9
  10. Schwab CW, Kauder DR. Trauma in the geriatric patient. Arch Surg 1992;127:701-6 https://doi.org/10.1001/archsurg.1992.01420060077011
  11. Scalea TM, Simon HM, Duncan AO, Atweh NA, Sclafani SJ, Phillips TF, Shaftan GW. Geriatric blunt multiple trauma: Improved survival with early invasive monitoring. J Trauma 1990;30:129-36
  12. Trunkey DD, Lewis FR. Chest trauma. Surg Clin North Am 1980;60:1541-9 https://doi.org/10.1016/S0039-6109(16)42298-X
  13. Lewis FR. Thoracic trauma. Surg Clin North Am 1982;62:97 https://doi.org/10.1016/S0039-6109(16)42636-8
  14. Richardson JD, McElevein RB, Trinkle JK. First rib fracture: A hallmark of severe trauma. Ann Surg 1975;181:251
  15. Jones KW. Thoracic trauma. Surg Clin North Am 1980;60:957-81 https://doi.org/10.1016/S0039-6109(16)42194-8
  16. Wilson JM, Boren CH Jr, Peterson SR, Thomas AN. Traumatic hemothorax: Is decortications necessary? J Thorac Cardiovasc Surg 1979;77:489-95
  17. Shorr RM, Crittenden M, Indeck M, Hartunian SL, Rodriguez A. Blunt thoracic trauma Analysis of 515 patients. Ann Surg 1987;206:200-5
  18. Miller LA. Chest wall, lung, and pleural space trauma. Radiol Clin North Am 2006;44:213-24 https://doi.org/10.1016/j.rcl.2005.10.006
  19. Wilson RF, Murray C, Antonenko DR. Nonpenetrating thoracic injuries. Surg Clin North Am 1977;57:17-36 https://doi.org/10.1016/S0039-6109(16)41131-X
  20. Perry JF Jr, Galway CF. Chest injury due to blunt trauma. J Throac Cardiovasc Surg 1965;49:684
  21. Gray HK, Fryfogle JD. Thoracic injuries in world war II US armed forces. MJ 1951;2:1127-1150
  22. Roger S, Hiram CP, Laman AG, Robert LF. Indications for thoracotomy following penetrating thoracic injury. J Trauma 1977;17:493 https://doi.org/10.1097/00005373-197707000-00002
  23. Cordice JWV, Cabezon J. Chest trauma with pneumothorax and hemothorax. Review of experience with 502 cases. J Thorac Cardiovasc Surg 1965;50:316