[How often is a chest tube needed following thoracic trauma in the severely injured-and when is more needed? : Data from a Swiss trauma center for planning of resources and surgical training].
- 2020-10-09
Published in:
- Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen. - 2020
Emergency surgery
Minimum intervention number
Specialist medical training
Thoracic injury
Trauma center
English
BACKGROUND AND OBJECTIVE
With respect to the resource and training requirements of a Swiss trauma center, we wanted to know how frequently relevant thoracic injuries occur and how often specialized thoracic surgery is needed.
MATERIAL AND METHODS
Retrospective analysis of all severely injured patients with a new injury severity score (NISS) ≥8 from 2010-2017 with respect to relevant thoracic injuries (abbreviated injury scale, AIS thorax without thoracic vertebral injuries ≥2).
RESULTS
In the 7‑year observational period 2839 patients with NISS ≥8 were treated as an emergency. Of these 791 (27.9%) suffered a relevant injury in the thoracic region and 27.1% (n = 215) of them required a thoracic intervention, which in 86.5% (n = 186) corresponded to a thoracic drainage only and in 13.5% (n = 29) to an extended intervention. In 19 cases following relevant thoracic injury, a thoracic surgeon was also required, 4 times immediately and 4 times within 24 h of hospital arrival. On average, 30 emergency thoracic drainage insertions per year corresponded to 1-2 interventions per surgeon in training.
CONCLUSION
In the observational period only 1% of all relevant thoracic injuries required emergency thoracic surgical care beyond a pleural drainage. Given this low rate, for efficiency and cost reasons a thoracic surgery on-call service appears to be appropriate and compulsory attendance is not needed; however, the capability to insert a thoracic drainage must be appropriately assured by surgical training. In view of the number of cases observed per trainee, the minimum number of interventions required according to specialty training regulations should be well achievable.
With respect to the resource and training requirements of a Swiss trauma center, we wanted to know how frequently relevant thoracic injuries occur and how often specialized thoracic surgery is needed.
MATERIAL AND METHODS
Retrospective analysis of all severely injured patients with a new injury severity score (NISS) ≥8 from 2010-2017 with respect to relevant thoracic injuries (abbreviated injury scale, AIS thorax without thoracic vertebral injuries ≥2).
RESULTS
In the 7‑year observational period 2839 patients with NISS ≥8 were treated as an emergency. Of these 791 (27.9%) suffered a relevant injury in the thoracic region and 27.1% (n = 215) of them required a thoracic intervention, which in 86.5% (n = 186) corresponded to a thoracic drainage only and in 13.5% (n = 29) to an extended intervention. In 19 cases following relevant thoracic injury, a thoracic surgeon was also required, 4 times immediately and 4 times within 24 h of hospital arrival. On average, 30 emergency thoracic drainage insertions per year corresponded to 1-2 interventions per surgeon in training.
CONCLUSION
In the observational period only 1% of all relevant thoracic injuries required emergency thoracic surgical care beyond a pleural drainage. Given this low rate, for efficiency and cost reasons a thoracic surgery on-call service appears to be appropriate and compulsory attendance is not needed; however, the capability to insert a thoracic drainage must be appropriately assured by surgical training. In view of the number of cases observed per trainee, the minimum number of interventions required according to specialty training regulations should be well achievable.
- Language
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- English
- Open access status
- hybrid
- Identifiers
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- DOI 10.1007/s00104-020-01292-7
- PMID 33034700
- Persistent URL
- https://roar.hep-bejune.ch/global/documents/24592
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