Clinical features and classification of thoracic injuries with multiple trauma in 10738 patients

Objective To analyze the new features of the thoracic injuries in recent years to explore the classification and the corresponding therapies. Methods The clinical data of 10 738 patients with severe injuries (their AIS ≥ 3 and the period during injury and hospitalization 24 hours) in 1993 1998 were collected from various places. The patients with thoracic injuries were divided into simple thoracic injury group, thoracic injury with multiple trauma group and thoracic leading multiple trauma group. In all the groups, the previous data of thoracic injury and the changes of clinical and epidemic features were analyzed. Results The hospitalization of thoracic trauma was doubled in recent years. The thoracic injuries were mainly caused by traffic accidents, sharp/blunt instruments and falls. Males aging 20 50 years were in high risk of thoracic injuries. About 57.9% of the patients suffered from severe thoracic injuries with ISS ≥ 16. Meanwhile, the patients with severe injuries suffering from hemopneumothorax, pulmonary contusion, bronchia rupture, acute respiratory distress syndrome, heart injury, multi organ thoracic injuries, systemic multiple trauma and multiple organ dysfunction syndrome increased significantly. About 61.2% of thoracic injuries were complicated by multiple trauma, which worsened the damage. Non surgical therapy for thoracic injury was developed better than the surgical and pre hospital treatments. Conclusions Thoracic injury has become an important kind of trauma. More cooperation should be made between the surgical treatment of thoracic injuries and the multiple trauma research. We also suggest making new criteria for the classification and the corresponding new operative methods for multiple trauma and heart injuries made by sharp instruments.