Thoracic Trauma

Question 1

Cabon, VCOT, 2015:
Thoracic bite trauma

1. Of the patients that had normal respiratory patterns, what % had thoracic radiographic lesions?
2. What % of dogs had flail chest?
3. Factors that were prognostic for the need for exploratory thoracotomy?
4. Pulmonary contusions were associated with what?
5. Rib fractures were associated with what?
6. Mortality rate?
7. Long-term outcomes?

Answer 1

Cabon, VCOT, 2015:

1. Of the patients that had normal respiratory patterns, 22% had thoracic radiographic lesions
2. 20% had flail chest
3. Factors that were prognostic for the need for exploratory thoracotomy: penetrating injury, >3 radiographic lesions, or both
4. Pulmonary contusions were associated with pneumothorax
5. Rib fractures were associated with pleural effusion
6. Mortality rate: 15%
7. Long-term outcomes were excellent

Question 2

McCarthy, VCOT, 2018:
Prognostication in canine rib fractures

1. Which score was correlated with risk factors?
2. Animal Trauma Triage (ATT) scores of non-survivors?
3. What ATT score had a 88% sensitivity and 81% specificity for predicting mortality?

Answer 2

McCarthy, VCOT, 2018:

1. Only the ATT score was correlated with risk factors
2. ATT scores of non-survivors was 5 or greater
3. ATT score of 7 or greater had a 88% sensitivity and 81% specificity for predicting mortality - a 1-point increase in ATT score corresponded to 2 times decreased likelihood of survival

Question 3

Lux, JAVMA, 2018:
Thoracic trauma in dogs

1. What % of the dogs had flail chest?
2. What % of the dogs had 3 or more rib fractures?
3. What % of dogs required thoracotomy?
4. Mortality rate?
5. What was associated with outcome?
6. Mean Animal Trauma Triage (ATT) score of non-survivors?
7. What ATT score was associated with 5 times the odds of survival?
8. What % of dogs had SIRS pre-op vs post-op, and was SIRS associated with survival?
9. Mortality rate associated with SIRS?

Answer 3

Lux, JAVMA, 2018:

1. 25% had flail chest
2. 25% had 3 or more rib fractures
3. 78% required thoracotomy
4. Mortality rate: 15%
5. ATT score was associated with outcome
6. Mean ATT score of non-survivors was 8
7. ATT score <7 had 5 times the odds of survival
8. 55% had pre-op SIRS vs 34% had post-op SIRS; SIRS was not associated with survival
9. Mortality rate associated with SIRS was 24%

Question 4

Lux, JAVMA, 2018:
Thoracic trauma in cats

1. What % of cats required intrathoracic surgery?
2. Overall peri-op mortality rate?
3. Mean Animal Trauma Triage (ATT) score for survivors vs non-survivors?

Answer 4

Lux, JAVMA, 2018:

1. 65% required intrathoracic surgery
2. 13% peri-op mortality rate
3. Mean ATT score was 6.4 for survivors vs 10 for non-survivors