Differences in clinical characteristics and outcomes for blunt versus penetrating traumatic pulmonary pseudocysts

Traumatic pulmonary pseudocysts (TPPs) are under-reported in blunt trauma and rarely reported in penetrating trauma. Little is known about the impact of injury mechanism on the pathophysiology or the risk factors that predispose to worse patient outcomes. We hypothesized that blunt and penetrating T...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of emergency medicine 2021-07, Vol.45, p.433-438
Main Authors: Beattie, Genna, Cohan, Caitlin M., Tang, Annie, Yasumoto, Eric, Victorino, Gregory P.
Format: Article
Language:English
Subjects:
Computed tomography
Contusions
Cysts
Emergency medical care
Hemoptysis
Hemorrhage
Hemothorax
Infections
Injuries
Intervention
Intubation
Lungs
Morbidity
Ostomy
Patients
Pneumothorax
Risk factors
Statistical analysis
Thoracic trauma
Trauma
Traumatic pneumatocele
Traumatic pulmonary pseudocyst
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Traumatic pulmonary pseudocysts (TPPs) are under-reported in blunt trauma and rarely reported in penetrating trauma. Little is known about the impact of injury mechanism on the pathophysiology or the risk factors that predispose to worse patient outcomes. We hypothesized that blunt and penetrating TPPs have different clinical characteristics and outcomes. Computed tomography imaging was evaluated for patients presenting at a level 1 trauma center with confirmed TPP from 2011 to 2018. Diameter was determined by largest dimension of the dominant TPP. Clinical variables and TPP features were compared for blunt versus penetrating trauma by using comparative statistics and multivariable analysis.e A total of 101 TPP patients were identified (blunt = 64; penetrating = 37). In penetrating TPP, rates of concomitant pulmonary laceration, hemothorax, and pneumothorax, were, respectively, 4.5, 3.1, and 1.4 times higher than for blunt TPP. Concomitant rib fracture was twice as common in blunt TPP as in penetrating TPP (69% versus 32%). For penetrating injury, the risk of complications related to TPP was increased (aOR = 5.3), specifically persistent/recurrent pneumothorax (aOR = 10.4). All deaths resulted from pulmonary hemorrhage (blunt = 3, penetrating = 2). Regardless of mechanism, air-fluid level and hemoptysis correlated with death (p 
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2020.09.048