Table 1.
Demographic an clinical characteristics of patients with ‘major thoracic trauma’
| NON-SURVIVORS | ||||||||
| TOTAL | SURVIVORS | Total death | Immediate death | Early death | Delayed death | Late death | MISSING | |
| <1h | 1h to 6h | 6h to 1 week | >1 week | |||||
| Patient characteristics | ||||||||
| Sex, male | 18532 (76.2) | 17489 (76.4) | 1043 (72.4) | 259 (74.2) | 173 (70.0) | 231 (73.3) | 380 (71.8) | 0 (0) |
| Age | 55.0 ± 18.9 | 54.3 ± 18.6 | 65.9 ± 19.8 | 56.5 ± 21.1 | 59.7 ± 20.5 | 67.6 ± 19.0 | 73.8 ± 14.8 | 0 (0) |
| Anticoagulants | 3625 (17.6) | 3258 (17.7) | 367 (41.3) | 27 (16.4) | 43 (35.2) | 87 (34.4) | 210 (52.6) | 5080 (20.9) |
| ASA 3/4 | 3578 (16.1) | 3055 (14.5) | 523 (44.4) | 62 (25.1) | 50 (27.3) | 126 (47.5) | 285 (59.1) | 2065 (8.5) |
| Accident mechanism | ||||||||
| Blunt | 22241 (95.3) | 20972 (95.5) | 1269 (92.0) | 284 (85.5) | 210 (89.0) | 282 (93.4) | 493 (96.7) | 989 (4.1) |
| Car / lorry | 6824 (28.2) | 6430 (28.2) | 394 (27.6) | 117 (33.8) | 65 (26.7) | 85 (27.2) | 127 (24.1) | 140 (0.6) |
| Motorbike | 3895 (16.1) | 3780 (16.6) | 115 (8.1) | 39 (11.3) | 23 (9.5) | 26 (8.3) | 27 (5.1) | 140 (0.6) |
| Bicycle | 2213 (9.1) | 2146 (9.4) | 67 (4.7) | 17 (4.9) | 13 (5.3) | 14 (4.5) | 23 (4.4) | 140 (0.6) |
| Pedestrian | 913 (3.8) | 808 (3.5) | 105 (7.4) | 25 (7.2) | 19 (7.8) | 21 (6.7) | 40 (7.6) | 140 (0.6) |
| High fall, ≥3m | 3454 (14.3) | 3231 (14.2) | 223 (15.6) | 56 (16.2) | 50 (20.6) | 41 (13.1) | 76 (14.4) | 140 (0.6) |
| Low fall, <3m | 4261 (17.6) | 3957 (17.4) | 304 (21.3) | 14 (4.0) | 27 (11.1) | 80 (25.6) | 183 (34.8) | 140 (0.6) |
| Other | 2632 (10.9) | 2413 (10.6) | 219 (15.3) | 78 (22.5) | 46 (18.9) | 45 (14.4) | 50 (9.5) | 140 (0.6) |
| Prehospital vital signs | ||||||||
| GCS ≤8 | 1642 (7.3) | 1010 (4.8) | 632 (48.0) | 276 (85.2) | 132 (57.9) | 113 (39.8) | 111 (23.0) | 1942 (8.0) |
| SBP, mmHg | 134.5 ± 31.9 | 136.5 ± 28.7 | 98.2 ± 56.5 | 42.5 ± 52.8 | 87.1 ± 50.5 | 108.6 ± 46.7 | 125.0 ± 42.8 | 3127 (12.9) |
| SBP ≤90mmHg | 1692 (8.0) | 1246 (6.2) | 446 (40.2) | 184 (81.1) | 93 (50.8) | 78 (30.8) | 91 (20.4) | 3127 (12.9) |
| SpO2 <94% | 3295 (34.0) | 2956 (32.3) | 339 (64.9) | 81 (89.0) | 64 (75.3) | 72 (60.0) | 122 (54.0) | 14655 (60.2) |
| Prehospital management | ||||||||
| Prehospital time, min | 63.9 ± 30.7 | 63.8 ± 30.5 | 66.5 ± 32.4 | 63.2 ± 27.9 | 61.9 ± 26.2 | 73.2 ± 37.9 | 66.7 ± 33.5 | 3716 (15.3) |
| Pleural decompression | 793 (7.1) | 632 (6.0) | 161 (21.4) | 75 (42.6) | 25 (19.1) | 30 (18.0) | 31 (11.1) | 13116 (53.9) |
| Tranexamic acid | 1639 (7.3) | 1444 (6.8) | 195 (14.8) | 64 (20.4) | 33 (14.5) | 46 (16.0) | 52 (10.6) | 1836 (7.5) |
| Intubation | 2097 (18.0) | 1637 (15.0) | 460 (59.4) | 162 (90.5) | 90 (66.7) | 101 (59.4) | 107 (36.8) | 12662 (52.0) |
| Volume, ml | 660.4 ± 519.4 | 643.0 ± 492.4 | 953.5 ± 800.4 | 1231.6 ± 914.9 | 1094.3 ± 802.4 | 930.4 ± 797.5 | 734.6 ± 648.2 | 14876 (61.1) |
| Vital signs on admission | ||||||||
| SBP, mmHg | 136.0 ± 30.8 | 138.2 ± 27.2 | 96.4 ± 54.2 | 35.2 ± 52.7 | 81.1 ± 49.6 | 112.4 ± 37.8 | 124.8 ± 33.9 | 1310 (5.4) |
| SBP ≤90mmHg | 1554 (6.8) | 1069 (4.9) | 485 (39.6) | 208 (84.6) | 120 (56.9) | 75 (26.7) | 82 (16.8) | 1310 (5.4) |
| SpO2 <94% | 2111 (20.1) | 1823 (18.4) | 288 (48.5) | 88 (84.6) | 57 (57.0) | 58 (42.0) | 85 (33.7) | 13827 (56.8) |
| Laboratory values on admission | ||||||||
| Haemoglobin, g dl−1 | 13.5 ± 2.1 | 13.7 ± 1.9 | 11.0 ± 2.9 | 9.6 ± 3.5 | 10.4 ± 3.1 | 11.2 ± 2.8 | 11.9 ± 2.3 | 760 (3.1) |
| Platelets, ×109 l−1 | 230.6 ± 77.6 | 233.5 ± 75.6 | 182.7 ± 93.1 | 111.0 ± 75.5 | 168.2 ± 84.9 | 179.3 ± 85.2 | 210.0 ± 93.0 | 13546 (55.7) |
| PT Quick, % | 90.4 ± 20.8 | 91.6 ± 19.6 | 65.3 ± 27.0 | 46.9 ± 27.5 | 59.1 ± 25.4 | 65.2 ± 26.1 | 72.2 ± 25.3 | 2054 (8.4) |
| INR | 1.1 ± 0.4 | 1.1 ± 0.4 | 1.6 ± 1.1 | 2.4 ± 1.9 | 1.7 ± 1.1 | 1.6 ± 1.1 | 1.4 ± 0.7 | 1554 (6.4) |
| Coagulopathy | 2181 (9.6) | 1682 (7.8) | 499 (45.2) | 90 (73.8) | 112 (58.3) | 130 (45.1) | 167 (33.2) | 1537 (6.3) |
| Base excess, +/– | −1.4 ± 4.5 | −1.0 ± 3.7 | −7.8 ± 9.2 | −15.6 ± 10.2 | −11.9 ± 9.7 | −7.6 ± 8.6 | −3.2 ± 5.4 | 5217 (21.4) |
| Management on admission | ||||||||
| Intubation | 808 (6.9) | 719 (6.6) | 89 (11.5) | 12 (6.7) | 31 (23.0) | 11 (6.5) | 35 (12.0) | 12662 (52.0) |
| Pleural decompression | 3012 (12.4) | 2648 (11.6) | 364 (25.3) | 96 (27.5) | 89 (36.0) | 73 (23.2) | 106 (20.0) | 0 (0) |
| Tranexamic acid | 1301 (12.6) | 1072 (11.1) | 229 (34.4) | 50 (34.2) | 58 (50.9) | 55 (38.7) | 66 (25.0) | 14008 (57.6) |
| Transfusion, PRC | 1345 (5.6) | 907 (4.0) | 438 (32.8) | 124 (45.9) | 137 (59.6) | 89 (29.0) | 88 (16.6) | 104 (0.4) |
| Massive Transfusion >10PRC | 176 (0.7) | 77 (0.3) | 99 (7.4) | 11 (4.1) | 40 (17.4) | 32 (10.4) | 16 (3.0) | 104 (0.4) |
| Volume, ml | 977.2 ± 1266.4 | 933.1 ± 1190.9 | 1615.0 ± 1965.0 | 1250.1 ± 1117.6 | 2453.6 ± 2343.3 | 1915.1 ± 2189.3 | 1293.7 ± 1908.2 | 14876 (61.1) |
| Haemostatic treatment | 1623 (15.6) | 1334 (13.7) | 289 (42.7) | 63 (42.3) | 71 (61.7) | 70 (47.6) | 85 (32.0) | 13931 (57.3) |
| Emergency surgery | 3165 (13.0) | 2776 (12.1) | 389 (27.0) | 77 (22.1) | 99 (40.1) | 95 (30.2) | 118 (22.3) | 0 (0) |
| Thoracotomy | 855 (3.9) | 661 (3.2) | 194 (15.1) | 70 (22.7) | 63 (28.4) | 33 (12.4) | 28 (5.8) | 2256 (9.3) |
| Complications | ||||||||
| Mulitple organ failure | 1301 (13.5) | 955 (10.4) | 346 (74.9) | 1 (50.0) | 22 (61.1) | 116 (79.5) | 207 (74.5) | 14694 (60.4) |
| Sepsis | 532 (5.6) | 402 (4.4) | 130 (29.5) | 0 (0) | 0 (0) | 12 (9.0) | 118 (43.7) | 14791 (60.8) |
| Injury severity | ||||||||
| ISS | 18.5 ± 9.1 | 17.8 ± 8.0 | 30.0 ± 16.1 | 34.9 ± 18.3 | 35.8 ± 18.7 | 29.5 ± 14.7 | 24.5 ± 11.3 | 0 (0) |
| AIS thorax = 3 | 14783 (60.8) | 14492 (63.3) | 291 (20.2) | 20 (5.7) | 22 (8.9) | 72 (22.9) | 177 (33.5) | 0 (0) |
| AIS thorax = 4 | 6461 (26.6) | 6010 (26.3) | 451 (31.3) | 95 (27.2) | 72 (29.1) | 96 (30.5) | 188 (35.5) | 0 (0) |
| AIS thorax = 5 | 2995 (12.3) | 2387 (10.4) | 608 (42.2) | 190 (54.4) | 120 (48.6) | 136 (43.2) | 162 (30.6) | 0 (0) |
| AIS thorax = 6 | 93 (0.4) | 3 (<0.1) | 90 (6.3) | 44 (12.6) | 33 (13.4) | 11 (3.5) | 2 (0.4) | 0 (0) |
| Prognosis | ||||||||
| RISC II, % | 6.4 ± 16.4 | 3.7 ± 9.0 | 48.5 ± 37.3 | 84.4 ± 22.2 | 61.3 ± 34.4 | 40.6 ± 33.6 | 23.6 ± 25.5 | 0 (0) |
| Cause of death | ||||||||
| Traumatic brain injury | 83 (6.2) | 20 (6.9) | 10 (4.4) | 25 (8.3) | 28 (5.5) | 108 (0.4) | ||
| Haemorrhage | 297 (22.3) | 135 (46.7) | 107 (46.7) | 46 (15.2) | 9 (1.8) | 108 (0.4) | ||
| Organ failure | 671 (50.4) | 70 (24.2) | 69 (30.1) | 168 (55.4) | 364 (71.2) | 108 (0.4) | ||
| Other | 281 (21.1) | 64 (22.1) | 43 (18.8) | 64 (21.1) | 110 (21.5) | 108 (0.4) | ||
Data are mean ± SD and number (%).
ASA, American Society of Anesthesiologist Physical Status Classification; GCS, Glasgow coma scale; SBP, systolic blood pressure; PT, prothromin time; INR, international normalised ratio; PRC, packed red cells; ISS, injury severity score; AIS, abbreviated injury scale; RISC-II, revised injury severity classification, version II.