Injury
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Two cases of tension pneumopericardium following stab wounds to the chest are reported. The first presented with delayed onset respiratory distress and a precordial systolic murmur, and was treated by thoracotomy. The second presented with acute cardiac tamponade and was treated by needle aspiration. The clinical and radiological features of tension pneumopericardium and its treatment are reviewed.
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By the TRISS methodology, probability of survival in injury can be estimated. It is based on a statistical analysis of outcome which is influenced by the severity of the injuries as expressed in the Injury Severity Score (ISS), the physiological function as expressed in the Trauma Score (TS) and the patient's age. We have used the TRISS formula in 206 patients with penetrating injury. ⋯ All the fatal cases had serious predisposing conditions: chronic pulmonary disease, alcoholism, and psychiatric illness. In penetrating injury, the patient's functional status at the start of treatment is of greater importance for the outcome than the anatomical severity. The concept of the methodology of TRISS for assessment of probability of survival seems useful for review and comparison in injury care.