P-185 * HOW MUCH THORACIC SURGERY IS NEEDED IN THE TREATMENT OF TRAUMA PATIENTS? RESULTS FROM A NATIONAL TRAUMA REGISTER

Objectives: Trauma patients often have severe injuries of the thorax. However, in most hospitals general thoracic surgeons do not participate in the treatment of trauma patients. This study aimed to reveal the need of general thoracic care in trauma patients by data analysis of a national trauma register. Methods: The national trauma register was analysed for the time period between 2002 and 2012 regarding the need of general thoracic care in trauma patients. The standard data collection was used to identify all patients with an injury severity score (SS) of 16 and above with a severe thoracic trauma. Using these searching criteria a total of 24 009 patients were recognized and included in this retrospective study. For all study patients the following clinicopathological factors were assessed: age, gender, type of trauma (penetrating versus blunt), severity of the thoracic trauma, rate of chest tubes, rate of thoracotomy/video-assisted thoracoscopic surgery (VATS), the level of trauma centre, ISS and the length of ICU/hospital stay were analysed. Results: A chest tube was inserted in 31% of the study patients while a thoracotomy/VATS was performed in 4.2% of the patients. Thoracic operations were rarely done in children (1.9%) whereas the frequency in the groups of 18-54, 55-74 and above 75 years were nearly similar (3.3%-4.3%). The in-hospital mortality was more than twice as high, when a thoracic operation was performed (7.3% vs 3.3%) while the cause of trauma itself had a low influence in the rate of operations. But even the injury score was higher in patients undergoing a thoracic operation (ISS >25 vs <25 leads to 2.6% vs 4.9%). Conclusions: Knowledge of thoracic surgery is mandatory in management of trauma patients. The prognosis is worse, if a thoracic operation is necessary. Especially, these trauma patients deserve the best treatment, i.e. a thoracic operation by a specialized team. Disclosure: No significant relationships.