Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Evaluation of lung injury score as a prognostic factor of critical care management in multiple trauma patients with chest injury

흉부외상이 동반된 다발성 외상환자에서 폐손상 점수가 중환자실 치료에 미치는 영향

  • 한국남 (서울대병원 중증외상센터) ;
  • 최석호 (서울대병원 중증외상센터) ;
  • 김영철 (서울대병원 중증외상센터) ;
  • 이경학 (서울대병원 중증외상센터) ;
  • 이수언 (서울대병원 중증외상센터) ;
  • 정기영 (서울대병원 중증외상센터) ;
  • 서길준 (서울대병원 중증외상센터)
  • Received : 2011.11.02
  • Accepted : 2011.11.30
  • Published : 2011.12.31
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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.

Keywords

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