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Revista do Colégio Brasileiro de Cirurgiões

Print version ISSN 0100-6991On-line version ISSN 1809-4546

Abstract

FONTELLES, Mauro José Pantoja  and  MANTOVANI, Mario. Thoracic trauma: a risk analysis of pulmonary complications following closed tube thoracostomy. Rev. Col. Bras. Cir. [online]. 2000, vol.27, n.6, pp.400-407. ISSN 0100-6991.  http://dx.doi.org/10.1590/S0100-69912000000600008.

The objective of this study was to analyse the risk factors for the development of thoracic infections after tube thoracostomy. Although technically simple, this procedure, 1 to 25 percent of the patients develop some type of intra or post-operative complications. A total of 167 patients, submitted to emergency tube thoracostomy, were admitted and stratified into two groups selected by randomic sampling to a cohorts accompanying study. One hundred and four patients, without antibiotic therapy, were considered as been the control group; and, 63 patients using cefalotin in post-operative as the experimental group. The mean age of the patients in the control group was 26.8±8.9 years (range, 13 - 53), and 24.9±7.9 years (range, 15 - 57) for experimental group, predominating the male sex (95.2%) in both studied groups. The penetrating chest trauma was present in 92.8% of the patients, with a higher incidence of stab wounds (58.7%) in contrast to gunshot wounds (24.6%). Thoracic complications were present in 35 patients (33.7%) of the control group, whereas, in the experimental group, only 18 patients (28.6%) developed this kind of complication. In the statistic significance analysis, the bivariate model indicated that the variable trauma type and the duration of pleural space drainage were the most relevant ones as predictive factors for infections complications. In the multivariate logistic regression, the variables blunt chest trauma, length of hospital stay and drainage blood volume higher than 500 ml, when associated, influenciated positively on the occurrence of these complications.

Keywords : Trauma; Thoracic trauma; Pleural drainage; Risk factors; Logistic regression.

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