J Korean Soc Traumatol.  2011 Dec;24(2):105-110.

Evaluation of Lung Injury Score as a Prognostic Factor of Critical Care Management in Multiple Trauma Patients with Chest Injury

Affiliations
  • 1Trauma Center, Seoul National University Hospital, Korea. hdoc@snu.ac.kr
  • 2Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Korea.
  • 3Department of Surgery, Seoul National University Hospital, Korea.
  • 4Department of Orthopedic Surgery, Seoul National University Hospital, Korea.
  • 5Department of Neurosurgery, Seoul National University Hospital, Korea.
  • 6Department of Emergency Medicine, Seoul National University Hospital, Korea.

Abstract

PURPOSE
Chest injuries in multiple trauma patients are major predisposing factor for increased length of stay in intensive care unit, prolonged mechanical ventilator, and respiratory complications such as pneumonia. The aim of this study is the evaluation of lung injury score as a risk factor for prolonged management in intensive care unit (ICU).
METHODS
Between June to August in 2011, 46 patients admitted to shock and trauma center in our hospital and 24 patients had associated chest damage without traumatic brain injury. Retrospectively, we calculated injury severity score (ISS), lung injury score, and the number of fractured ribs and performed nonparametric correlation analysis with length of stay in ICU and mechanical ventilator support.
RESULTS
Calculated lung injury score(<48 hours) was median 1(0-3) and ISS was median 30(8-38) in study population. They had median 2(0-14) fractured ribs. There were 2 bilateral fractures and 2 flail chest. Ventilator support was needed in 11(45.8%) of them for median 39 hours(6-166). The ISS of ventilator support group was median 34(24-34) and lung injury score was median 1.7(1.3-2.5). Tracheostomy was performed in one patient and it was only complicated case and ICU stay days was median 9(4-16). In correlation analysis, Lung injury score and ISS were significant with the length of stay in ICU but the number of fractured ribs and lung injury score were predicting factors for prolonged mechanical ventilator support.
CONCLUSION
Lung injury score could be a possible prognostic factor for the prediction of increased length of stay in ICU and need for mechanical ventilator support.

Keyword

Chest trauma; Lung injury score; Injury severity score; Pulmonary contusion

MeSH Terms

Brain Injuries
Critical Care
Flail Chest
Humans
Injury Severity Score
Intensive Care Units
Length of Stay
Lung
Lung Injury
Multiple Trauma
Pneumonia
Retrospective Studies
Ribs
Risk Factors
Self-Help Groups
Shock
Thoracic Injuries
Thorax
Tracheostomy
Trauma Centers
Ventilators, Mechanical
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