Optimizing outcomes in emergency room thoracotomy: A 20-year experience in an urban level I trauma center

Gerardo Gomez, Alison Fecher, Theresa Joy, Ivanesa Pardo, Lewis Jacobson, Heather Kemp

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Emergency room thoracotomy (ERT) has remained a last resort tool of resuscitation in the management of patients with major trauma. The medical records of all patients undergoing ERT for penetrating chest trauma from January 1, 2000 through April 30, 2008 were retrospectively reviewed. The data from this study were added to data collected in two previous studies conducted at our institution for meta-analysis. A total of 102 ERTs were performed. There were 28 Class I patients (27.4%), 58 Class II (56.8%), six Class III (5.8%), and 11 Class IV (10.7%). The number of ERTs performed on Class I patients has decreased from 58.3 per cent in the 1995 group to 35.4 per cent in the 1999 group. There was an overall survival of 7.8 per cent in the current period of review. Overall survival in the 1995 group was 2.5 per cent, 1999 was 2.7 per cent, and 2008 was 7.8 per cent. The majority of the survival benefit occurs in patients who have electrical activity and a blood pressure when examined in the emergency department (Class III and IV). We intend to do future prospective research to further clarify the Class II patients when evaluating the type of rhythm shown on electrocardiogram tracing to move away from the generic pulseless electrical activity category.

Original languageEnglish
Pages (from-to)406-410
Number of pages5
JournalAmerican Surgeon
Volume76
Issue number4
StatePublished - Apr 2010

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Trauma Centers
Thoracotomy
Hospital Emergency Service
Survival
Wounds and Injuries
Resuscitation
Medical Records
Meta-Analysis
Electrocardiography
Thorax
Blood Pressure
Research

ASJC Scopus subject areas

  • Surgery

Cite this

Gomez, G., Fecher, A., Joy, T., Pardo, I., Jacobson, L., & Kemp, H. (2010). Optimizing outcomes in emergency room thoracotomy: A 20-year experience in an urban level I trauma center. American Surgeon, 76(4), 406-410.

Optimizing outcomes in emergency room thoracotomy : A 20-year experience in an urban level I trauma center. / Gomez, Gerardo; Fecher, Alison; Joy, Theresa; Pardo, Ivanesa; Jacobson, Lewis; Kemp, Heather.

In: American Surgeon, Vol. 76, No. 4, 04.2010, p. 406-410.

Research output: Contribution to journalArticle

Gomez, G, Fecher, A, Joy, T, Pardo, I, Jacobson, L & Kemp, H 2010, 'Optimizing outcomes in emergency room thoracotomy: A 20-year experience in an urban level I trauma center', American Surgeon, vol. 76, no. 4, pp. 406-410.
Gomez G, Fecher A, Joy T, Pardo I, Jacobson L, Kemp H. Optimizing outcomes in emergency room thoracotomy: A 20-year experience in an urban level I trauma center. American Surgeon. 2010 Apr;76(4):406-410.
Gomez, Gerardo ; Fecher, Alison ; Joy, Theresa ; Pardo, Ivanesa ; Jacobson, Lewis ; Kemp, Heather. / Optimizing outcomes in emergency room thoracotomy : A 20-year experience in an urban level I trauma center. In: American Surgeon. 2010 ; Vol. 76, No. 4. pp. 406-410.
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