The incidence of emergency thoracotomy in thoracic trauma. 7000 cases of thoracic trauma (T.T.) treated in the period of 1978-1995

With intensive care, pleural drainage and judicious physiotherapy most thoracic injuries can be treated adequately. We reviewed the experience with urgent thoracotomy, to compare the relative indications and injury pattern after blunt versus penetrating trauma. Among 7000 patients with thoracic trauma (T.T.), excluding 319 resuscitative thoracotomy, 83 required urgent thoracotomy. A thoracotomy was necessary in 14% of the patients with blunt thoracic trauma, and 33% with penetrating trauma. Thoracotomy for penetrating trauma was performed earlier and had better results than thoracotomy for blunt trauma. Seventy-five percent of penetrating trauma were operated in the first hour after admission against 29% of blunt trauma. Postoperative mortality for penetrating trauma was three times lower than for blunt trauma (18% versus 56%). Surgical procedure depends on the type and extend of the thoracic and general injuries and on the patients general condition.