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Journal of the Korean Society of Traumatology 2011;24(2):105-110.
Evaluation of Lung Injury Score as a Prognostic Factor of Critical Care Management in Multiple Trauma Patients with Chest Injury
Kook Nam Han, Seok Ho Choi, Yeong Cheol Kim, Kyoung Hak Lee, Soo Eon Lee, Ki Young Jeong, Gil Joon Suh
1Trauma Center, Seoul National University Hospital, Korea. hdoc@snu.ac.kr
2Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Korea.
3Department of Surgery, Seoul National University Hospital, Korea.
4Department of Orthopedic Surgery, Seoul National University Hospital, Korea.
5Department of Neurosurgery, Seoul National University Hospital, Korea.
6Department of Emergency Medicine, Seoul National University Hospital, Korea.
흉부외상이 동반된 다발성 외상환자에서 폐손상 점수가 중환자실 치료에 미치는 영향
한국남1,2∙최석호1,3∙김영철1,3∙이경학1,4∙이수언1,5∙정기영1,6∙서길준1,6
서울대병원 중증외상센터1,
서울대병원 흉부외과2,
서울대병원 외과3,
서울대병원 정형외과4,
서울대병원 신경외과5,
서울대병원 응급의학과6
Received: 2 November 2011   • Revised: 23 November 2011   • Accepted: 30 November 2011
Abstract
PURPOSE
Chest injuries in multiple trauma patients are major predisposing factor for increased length of stay in intensive care unit, prolonged mechanical ventilator, and respiratory complications such as pneumonia. The aim of this study is the evaluation of lung injury score as a risk factor for prolonged management in intensive care unit (ICU).
METHODS
Between June to August in 2011, 46 patients admitted to shock and trauma center in our hospital and 24 patients had associated chest damage without traumatic brain injury. Retrospectively, we calculated injury severity score (ISS), lung injury score, and the number of fractured ribs and performed nonparametric correlation analysis with length of stay in ICU and mechanical ventilator support.
RESULTS
Calculated lung injury score(<48 hours) was median 1(0-3) and ISS was median 30(8-38) in study population. They had median 2(0-14) fractured ribs. There were 2 bilateral fractures and 2 flail chest. Ventilator support was needed in 11(45.8%) of them for median 39 hours(6-166). The ISS of ventilator support group was median 34(24-34) and lung injury score was median 1.7(1.3-2.5). Tracheostomy was performed in one patient and it was only complicated case and ICU stay days was median 9(4-16). In correlation analysis, Lung injury score and ISS were significant with the length of stay in ICU but the number of fractured ribs and lung injury score were predicting factors for prolonged mechanical ventilator support.
CONCLUSION
Lung injury score could be a possible prognostic factor for the prediction of increased length of stay in ICU and need for mechanical ventilator support.
Key Words: Chest trauma; Lung injury score; Injury severity score; Pulmonary contusion


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