• Akin Eraslan Balci, Tansel Ansal Balci, Sevval Eren, Refik Ulkü, Omer Cakir, and Nesimi Eren.
• Department of Thoracic and Cardiovascular Surgery, Dicle University School of Medicine, Diyarbakir, 21280, Turkey.
• Surg. Today. 2005 Jan 1;35(3):205-10.

PurposeThere is still much controversy regarding the optimal treatment for pulmonary contusion. Therefore, we examined the variables affecting patient outcomes over a 10-year period.MethodsWe retrospectively reviewed 107 consecutive patients with a mean age of 28 years, who were treated for pulmonary contusion during a 10-year period. Pulmonary perfusion scans were obtained for 11 patients. We used a pulmonary contusion score (PCS) of one-third of a lung = 3 and the entire lung = 9.ResultsOverall mortality was 15%, which increased to 24.4% in patients with a PCS of 7-9. The time taken for contusions to resolve was longer based on scan results than chest X-rays (42.6 vs 15.5 days, respectively). Concomitant thoracic injures were present in 64.5% of patients, and 29% had a flail chest. The factors predictive of mortality were age >/=60 years, an injury severity score (ISS) >/=25, transfusion of >/=4 units of blood, a PaO(2)/FIO(2) ratio of <300, concomitant flail chest, and a PCS of 7-9. The predictors for mechanical ventilation were age >/=60 years, concomitant flail chest, a PCS of 7-9, and an ISS >/=25. Mortality and the need for mechanical ventilation were higher in patients with nonisolated contusions than in those with isolated contusions.ConclusionsOptimizing patient outcome requires prompt diagnosis, appropriate maintenance of fluid volume, and selective mechanical ventilation.

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