Frequency of thoracic organ injuries in polytraumatized patients subjected to whole body computerized tomography

Cilj: dobiti podatke o učestalosti ozljeda toraksa u politraumatiziranih bolesnika podvrgnutih CT-u cijeloga tijela, usporediti učestalost ozljeda toraksa sa ozljedama glave i ekstremiteta, te zaključiti koja je od ozljeda najčešća s obzirom na spol i dob bolesnika. Ispitanici: u ovu retrospektivnu analizu uključeno je 286 pacijenata, koji su bili podvrgnuti CT-u cijeloga tijela u Kliničkom bolničkom centru Rijeka na Kliničkom zavodu za radiologiju - lokalitet Sušak zbog sumnje na politraumu, u razdoblju od 01.05.2020. do 01.05.2022. godine. Svi relevantni podaci za provođenje ovog istraživanja prikupljeni su iz informacijskog bolničkog informacijskog sustava (ISSA i IBIS). Rezultati: od ukupnog broja pacijenata (286), 225 (79%) bilo je muškoga spola, a 61 (21%) ženskoga spola. Pacijenti su podijeljeni u 10 dobnih skupina, od 1 do 9 godina, od 10 do 19 godina i tako dalje sve do 90+ godina. Najviše bolesnika podvrgnutih CT-u cijeloga tijela zbog sumnje na politraumu pripadalo je dobnom razredu od 40 do 49 godina, njih ukupno 54 (18,881%). Prosječna dob naših ispitanika jest 44,35 godina. Od svih pacijenata, 31 (10,8%) imao je uredan nalaz, dok je ostalih 255 (89,2%) imalo neku vrstu ozljede u nekoj od sljedećih regija tijela: koštanom sustavu (fraktura) njih 215 (84,3% od sveukupnog broja bolesnika sa pozitivnim nalazom), 201 bolesnik ozljedu torakalnih organa (78,8% od sveukupnog broja bolesnika), ozljedu abdomena njih 97 (38% od sveukupnog broja bolesnika sa pozitivnim nalazom), te ozljedu neurokranija 67 bolesnika (26,2% od sveukupnog broja bolesnika sa pozitivnim nalazom). Zabilježeno je ukupno 580 povreda različitih organskih sustava unutar sveukupnog broja povreda. Od 215 (koji čine 84,3% od ukupnog broja bolesnika) bolesnika koji su pretrpjeli neku vrstu frakture, 31 (12,1%) pretrpjelo je frakturu ekstremiteta, bilo gornjih ili donjih, 184 (72,1%) pretrpjelo je frakturu neke druge kosti u tijelu. Kod 40 (15,8%) bolesnika koji su imali pozitivan nalaz na neku ozljedu, nije zabilježena niti jedna fraktura. Fokusirajući se samo na ozljede toraksa, od svih 286 bolesnika u ovom istraživanju, 15 (5,24%) ih je imalo izoliranu ozljedu toraksa, 186 (65,04%) bolesnika koji su imali ozljedu toraksa u kombinaciji sa ozljedom nekog drugog dijela tijela, 54 (18,88%) bolesnika koji su imali ozljedu nekog drugog dijela tijela, ali ne i toraksa, te 31 (10,84%) bolesnik koji je imao potpuno uredan nalaz CT-a cijelog tijela. Najčešća ozljeda toraksa u politraumatiziranih pacijenata podvrgnutih CT-u cijeloga tijela bila je fraktura rebara. Dijagnosticirana je kod 135 (47,2%) bolesnika. Ozljeda s najmanjom učestalošću bila je laceracija jednjaka, koja je zabilježena samo kod jednog (0,35%) bolesnika. Najčešća ozljeda, ako isključimo kosti toraksa, bila je kontuzija pluća, koja je dijagnosticirana kod 94 (32,87%), bolesnika. Zaključak: u usporedbi s ostalim autorima koji su proveli slično istraživanje, možemo uočiti da se neki od ključnih podataka podudaraju s rezultatima koje smo dobili u ovome istraživanju.Aim: to obtain data on the frequency of thoracic injuries in polytraumatized patients undergoing whole-body CT, to compare the frequency of thoracic injuries with head and limb injuries and to conclude which of the injuries is the most common with regard to the gender and age of the patients Respondents: in this retrospective analysis, 286 patients were included, they underwent whole-body CT scan at Rijeka Clinical Hospital Center, Clinical Institute for Radiology - Sušak due to suspected polytrauma, in the period from May 1, 2020 until May 1, 2022. All relevant data for conducting this research were taken from the hospital information system, ISSA and IBIS Results: of the total number of patients (286), 225 (79%) were male and 61 (21%) were female. Patients are divided into 10 age groups, from 1 to 9 years, from 10 to 19 years and so on up to 90+ years. The majority of patients who underwent whole-body CT due to suspected polytrauma belonged to the age group of 40 to 49 years, a total of 54 of them (18,881%). The average age of our respondents is 44.35 years. Of all patients, 31 (10,8%) had a completely normal CT scan, while the other 255 (89,2%) had some kind of injury in one of the following regions of the body: bone (fracture) 215 of them (84,3% of of the total number of patients with a positive CT scan), 201 patients with thoracic organ injuries (78,8% of the total number of patients with a positive CT scan ), 97 of them with abdominal injuries (38% of the total number of patients with a positive CT scan) and 67 patients with neurocranial injuries (26,2% of the total number of patients with a positive CT scan ). A total of 580 injuries to various organ systems were recorded within the total number of injuries. Out of 215 (which make up 84.3% of the total number of patients) patients who suffered some kind of fracture, 31 (12,1%) suffered a fracture of the extremities, either upper or lower, 184 (72,1%) suffered a fracture some other bones in the body. In 40 (15,8%) patients who had a positive result of an injury, not a single fracture was recorded. Focusing only on thoracic injuries, of all 286 patients in this study, 15 (5.24%) had an isolated thoracic injury, 186 (65,04%) patients had a thoracic injury combined with an injury to another part of the body , 54 (18,88%) patients who had an injury to another part of the body, but not the thorax, and 31 (10,84%) patients who had a completely normal CT scan of the whole body. The most common thoracic injury in polytraumatized patients undergoing whole-body CT was rib fracture. It was diagnosed in 135 (47,2%) patients. The injury with the lowest frequency was laceration of the esophagus, which was recorded in only one (0,35%) patient. The most common injury, if we exclude the bones of the thorax, was lung contusion, which was diagnosed in 94 (32,87%) patients. Conclusion: in comparison with other authors who conducted similar research, we can see that some of the key data coincide with the results we obtained in this researc