Clinical Findings of O'Connor Associated with Thoracotomy After Penetrating Chest Trauma

Patient selection: penetrating chest trauma

Frequency of thoracotomy: 15%

Clinical findings predictive of operating room thoracotomy within 6 hours of admission:

(1) acidosis (low pH, based deficit, elevated blood lactate) with inadequate tissue perfusion

(2) persistent hemorrhage associated with the chest wound

There was considerable discordance between the level of shock and the admission blood pressure. Significant shock can occur with normal or near normal systolic blood pressures.

Clinical findings associated with mortality:

(1) pneumonectomy

(2) damage control thoracotomy