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Penetrating chest injuries in the firearm era.

机译：在枪支时代穿透胸伤。

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BACKGROUND: firearm wounds of the chest are now common at our institution. The management algorithm for firearm wounds has not been evaluated for this mode of injury. METHODS: records of all patients with penetrating chest injuries admitted to an urban tertiary hospital over 1 year were retrieved and analysed. RESULTS: there were 473 stab and 116 firearm wounds. In comparison to stab injuries firearm wounds had significantly more normal X-rays (14 vs. 5%), fewer pneumothoraces (15 vs. 37%), and more contusions (43 vs. 2%). The frequency of haemothoraces (34 vs. 23%) and haemopneumothoraces (36 vs. 35%) was similar in both groups. Stabbing caused all the 18 cardiac injuries. Associated abdominal injuries occurred in 8% of stab and 34% of firearm injuries. Pneumothoraces due to firearms were uncommon and rarely required drainage. More pneumothoraces were treated nonoperatively among firearm injuries in contrast to stabbing injuries where the opposite applied. The management of haemothorax and haemopneumothorax was similar in both groups that fulfilled the criteria for drainage. The rate of ICU admission was higher and the hospital-stay longer following firearm injuries. Fifty-nine patients died (10% of the total), 33 (28%) from the firearm injuries and 26 (6%) from stab-wounds. Early deaths were 1 and 3% for stabs and firearms, respectively. CONCLUSIONS: patients with firearm injuries reaching hospital suffered three times higher mortality and a longer ICU and hospital stay than those with stab injuries. However, early mortality was similar for both modes of injury and validates the continued application of the stab wound derived management algorithm to all modes of injury.
机译：背景：胸部火器伤在我们的机构中​​现在很普遍。尚未针对这种伤害模式评估枪支伤口的管理算法。方法：检索并分析所有在城市三级医院住院的1年以上穿透性胸外伤患者的病历。结果：刺伤473例，枪械伤116例。与刺伤相比，枪支伤口的X射线正常水平明显更高（14比5％），气胸较少（15比37％），挫伤更多（43比2％）。两组的血尿胸（34％对23％）和血气肺胸（36％对35％）的发生率相似。刺伤致全部18例心脏受伤。相关的腹部受伤发生在8％的刺伤和34％的枪械受伤中。由枪支引起的气胸不常见，很少需要引流。与之相反的是刺伤，在枪支伤亡中更多的气胸患者被非手术治疗。符合排泄标准的两组的血胸和血气胸的处理相似。枪支受伤后，ICU住院率更高，住院时间更长。 59名患者（占总数的10％）死亡，其中33人（占28％）死于枪支伤，26人（占6％）死于刀伤。刺伤和枪支的早期死亡分别为1％和3％。结论：枪伤致残的患者比刺伤致死率高三倍，ICU和住院时间更长。但是，两种损伤方式的早期死亡率相似，这证明了刺伤创面管理算法在所有损伤方式中的持续应用。

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