BACKGROUND: Penetrating Thoracoabdominal trauma, besides the diagnosis difficulty, deserve special attention with respect to the adopted strategy for the pleural space treatment. METHODS: Using the logistic regression model the authors analyzed 110 patients with penetrating Thoracoabdominal trauma, submitted to close tube thoracostomy and laparotomy. Pleural empyema complication was evaluated according to the level, incidence and others risk factors such as abdominal organ injuries, mechanism of injury, side of diaphragm injury, signs of hemorrhagic shock and others. Odds ratio (OR) was performed. Significance level was established for p<0.05. RESULTS: There were 91 males and 19 females with an age range between 13 and 63 years old. Mechanism of injury consisted of 50 stab wounds and 60 gunshot wounds. Pleural empyema occurred in four (3.6%) patients. In the statistic analysis this complication was related with hollow viscera (OR=3.1386, p=0.4005); left-side diaphragm injuries (OR=12.9884, p=0.1178); hemorrhagic shock (OR=23.9639, p=0.0250). CONCLUSION: We conclude there is a threefold higher risk for pleural empyema occurrence in patients with abdominal hollow viscera lesion, with 13-fold increase if this lesion was associated to left-side diaphragmatic injury; and also 24-fold increase in those patients presenting hemorrhagic shock at admission.
Pleural empyema; Thoracoabdominal injuries; Thoracic trauma; Abdominal trauma; Diaphragm injuries
