Unilateral post-traumatic pulmonary contusion: findings of a review

Surg Today. 2005;35(3):205-10. doi: 10.1007/s00595-004-2925-z.


Purpose: There is still much controversy regarding the optimal treatment for pulmonary contusion. Therefore, we examined the variables affecting patient outcomes over a 10-year period.

Methods: We retrospectively reviewed 107 consecutive patients with a mean age of 28 years, who were treated for pulmonary contusion during a 10-year period. Pulmonary perfusion scans were obtained for 11 patients. We used a pulmonary contusion score (PCS) of one-third of a lung = 3 and the entire lung = 9.

Results: Overall mortality was 15%, which increased to 24.4% in patients with a PCS of 7-9. The time taken for contusions to resolve was longer based on scan results than chest X-rays (42.6 vs 15.5 days, respectively). Concomitant thoracic injures were present in 64.5% of patients, and 29% had a flail chest. The factors predictive of mortality were age >/=60 years, an injury severity score (ISS) >/=25, transfusion of >/=4 units of blood, a PaO(2)/FIO(2) ratio of <300, concomitant flail chest, and a PCS of 7-9. The predictors for mechanical ventilation were age >/=60 years, concomitant flail chest, a PCS of 7-9, and an ISS >/=25. Mortality and the need for mechanical ventilation were higher in patients with nonisolated contusions than in those with isolated contusions.

Conclusions: Optimizing patient outcome requires prompt diagnosis, appropriate maintenance of fluid volume, and selective mechanical ventilation.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Cause of Death*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Combined Modality Therapy
  • Contusions / diagnosis*
  • Contusions / mortality*
  • Contusions / therapy
  • Female
  • Humans
  • Injury Severity Score
  • Lung Injury*
  • Male
  • Middle Aged
  • Probability
  • Retrospective Studies
  • Risk Assessment
  • Sex Distribution
  • Survival Analysis
  • Thoracic Injuries / diagnosis*
  • Thoracic Injuries / mortality*
  • Thoracic Injuries / therapy
  • Turkey / epidemiology
  • Wounds, Nonpenetrating / diagnosis
  • Wounds, Nonpenetrating / mortality
  • Wounds, Nonpenetrating / therapy