الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Penetrating injuries to the chest present a frequent and challenging problem, but the majority of these injuries can be managed non-operatively. The aim of this study was to describe the incidence of PCT and the ultimate techniques used for operative management, as well as the diagnosis, complications, morbidity and mortality.
The indications for thoracotomy after penetrating injury typically include shock, arrest at presentation, or initial thoracic hemorrhage. This latter indication is most commonly specified to mean greater than 15-20 mL/Kg of initial chest tube output, We therefore conducted a prospective review of trauma patients undergoing urgent thoracotomy specifically because of ongoing thoracic hemorrhage in an effort to better define indications for thoracotomy based on blood loss and subsequent outcomes.
The prospective review of patients who underwent an operative procedure following penetrating chest trauma was performed. The mechanism of injury, gender, age, physiological and outcome parameters, including transfusion requirement, indications for thoracotomy, intra-operative findings, operative procedures, LOS and rate of mortality were recorded.
This prospective study was conducted on 100 patients. Of these, 81 patients (77 stabbings, 4 gunshots) underwent a thoracotomy and 19 underwent median sternotomy within 60 minutes after the penetrating trauma, the median duration of surgery was 3 hours ranging from 2 to 5 hours.
Males predominated in this study, There were 94 (94%) male and 6 (6%) female patients, and their median age was 25 (range, 7-60) years.
This study showed that the median ICU stay was 2 days ranging from 1 to 3 days and mean LOS was 6 days.
In this study showed that MV was needed for 19 (20.9%) patients, they had significantly low GCS (P <0.001), SBP (P <0.001), and Hb (P = 0.003). In contrast, those had significantly high duration of surgery (P = 0.011), HR (P <0.001), initial ICT output (P <0.001) and diaphragmatic injury (P = 0.017) and cardiac injury (P = 0.013).
In this study showed that inotropes were needed for 24 (26.4%) patients, they had significantly low GCS (P <0.001), SBP (P <0.001), and Hb (P = 0.014). In contrast, those had significantly high HR (P <0.001), initial ICT output (P <0.001) and cardiac injury (P < 0.00001). Additionally, the clinical condition significantly differed (P = 0.007), with hemorrhagic shock and tamponade being higher in those who needed inotropes (79.2% and 20.8%, respectively) compared to those without inotropic use (65.7% and 7.5%, respectively).
This study showed that the Patients who died had a significantly position of trauma of front of chest and sub mammary (44.4% and 55.6% respectively) compared to survivors (5.5% and 0% respectively), lower SBP on presentation in the emergency room (71 ± 11 mm Hg) compared with those who survived (90 ± 9 mm Hg, p < 0.001) and lower hemoglobin level (6.4 ± 0.5) compared with those who survived (8.4 ± 1 , P <0.001). The overall mortality rate was 9% (n = 9). Mortality for patients with SWs was 5/96 (5.2%) compared with 4/4 (100%) for patients with GSWs this is because GSWs not common in our society . RV injury (P =0.03) was associated with mortality.