Neurologic outcome after emergency room thoracotomy for trauma

Christopher C. Baker, John J. Caronna, Donald Trunkey

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

The charts of 168 patients undergoing resuscitative thoracotomy for trauma in the emergency room at the San Francisco General Hospital from 1972 through 1978 were reviewed to assess factors affecting neurologic recovery after cardiac arrest. Forty-nine patients survived resuscitation and definitive operation, but 8 of them died in the first 24 hours postoperatively. Four patients in this group made some neurologic recovery (two good recoveries, two severe disabilities) but died later (12 to 44 days postoperatively) of septic complications. Thirteen nonsurvivors made no neurologic recovery before death. There were 33 long-term survivors (19.6 percent), 10 of whom were agonal or had no vital signs when first admitted to the emergency room. A persistent vegetative state developed in two patients who later died of sepsis (10 days and 14 months postoperatively). The remaining 32 patients all made good neurologic recovery that was apparent within 12 hours postoperatively. Transient amnesia was present during recovery in three patients. Wakefulness was the best prognostic sign of full neurologic recovery. In conclusion, emergency room thoracotomy can save a substantial number of moribund trauma patients who can be expected to sustain full neurologic recovery if they awaken within 12 hours.

Original languageEnglish (US)
Pages (from-to)677-681
Number of pages5
JournalThe American Journal of Surgery
Volume139
Issue number5
DOIs
StatePublished - 1980
Externally publishedYes

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Thoracotomy
Nervous System
Hospital Emergency Service
Wounds and Injuries
Persistent Vegetative State
Amnesia
San Francisco
Vital Signs
Wakefulness
Neurologic Manifestations
Heart Arrest
Resuscitation
General Hospitals
Survivors
Sepsis

ASJC Scopus subject areas

  • Surgery

Cite this

Neurologic outcome after emergency room thoracotomy for trauma. / Baker, Christopher C.; Caronna, John J.; Trunkey, Donald.

In: The American Journal of Surgery, Vol. 139, No. 5, 1980, p. 677-681.

Research output: Contribution to journalArticle

Baker, Christopher C. ; Caronna, John J. ; Trunkey, Donald. / Neurologic outcome after emergency room thoracotomy for trauma. In: The American Journal of Surgery. 1980 ; Vol. 139, No. 5. pp. 677-681.
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