J Korean Soc Emerg Med.  2004 Dec;15(6):452-455.

The Value of Grading of Pulmonary Contusion by the Chest CT Scanning

• Kim JJ
• Shin JH
• Jin W
• Hyun SY
• Lim YS
• Yang HJ
• Lee G
• Lee SK

Abstract

PURPOSE
Pulmonary contusion is the most common injury in patients with blunt chest trauma, and reported as 15~20% of multiple traumatic patients. In this study, we would like to predict a prognosis for pulmonary contusion easily at ED through the chest CT scanning.
METHODS
We reviewed medical records and chest CT findings of 190 pulmonary contusion patients retrospectively. Both lung were devided into 4 areas, RUL +RML, RLL, LUL, and LLL (RUL: right upper lobe, RML:right middle lobe, LUL:left upper lobe, LLL: left lower lobe). 3 point were given to each area, maximally. In each area, a ratio was measured as the longest pulmonary contusion length per the transverse axis length of lung on the largest pulmonary contusion image of chest CT scan. The score can be obtained by multiplying 3 to the ratio and raising fractions not lower than 0.5 to a unit. We classified to three groups as mild (PCS 0-2), moderate (3-5), and severe (6-12) PCS groups.
RESULTS
179 patients with pulmonary contusion were classified as 94 mild, 52 moderate, 33 severe pulmonary contusion groups by PCS. As PCS was high, PRF (Pao2/ FiO2) was decreasing, number of patients treated with mechanical ventilation was increasing, ICU stay was long, and a complication rate was increasing.
CONCLUSION
For patients with blunt chest trauma at ED which classified as severe PCS group (6-12), the patients need ICU admission and active treatment for a long time to reduce the mortality and complication rate.

Keyword

Lung; Contusions; Blunt injuries

MeSH Terms

Axis, Cervical Vertebra
Contusions*
Humans
Lung
Medical Records
Mortality
Prognosis
Respiration, Artificial
Retrospective Studies
Thorax*
Tomography, X-Ray Computed*
Wounds, Nonpenetrating