Thoracic Injuries: A Survey of 765 Patients Treated at the University Hospital, Uppsala, during the Years 1956-1969

During the period 1956-1969, a total of 765 patients with thoracic injuries - either isolated or combined with other injuries - were treated as in-patients at the University Hospital, Uppsala. The over-all mortality during this 14-year period was 9% (69/765). In patients with isolated thoracic injuries the mortality was 2% (9/447). In 5% (38/765) thoracotomy was performed. In general, however, active conservative measures were found adequate in most of these patients. In 8% (61/765) the use of a respirator was considered indicated - mainly because of flail chest. Our principles of treatment have remained unchanged by our experience during these years. The importance of the time factor in diagnosis and treatment for the outcome in patients with thoracic injuries is stressed.Thoracic injuries occupy a prominent place in the accident statistics of today (Chandler, 1957; Wulff et al., 1957; Johansson & Silander, 1959). An increase of both the number of injuries due to traffic accidents and the proportion of thoracic injuries among them has been reported (Solhem, 1963). During the years 1956-1969, a total of 765 patients with thoracic injuries were treated as in-patients at the University Hospital of Uppsala, and comprise the material of the present study. They included both patients from the hospital's own district and patients referred to us from other hospitals within a region representing about two million inhabitants. Out-patients are not included. Neither does the material include patients who were dead on arrival at the hospital. Thus the material is selected, with some over-representation of complex thoracic injuries during the period under review. The aim of this study was to consider the therapeutic principles in the light of experience gained, with special regard to indications for respirator treatment and for surgical intervention.