Abstract：
Thoracic trauma occurs in 20-25% of all trauma patients worldwide and represents the third cause of trauma-related mortality. Retained hemothorax (RH) is defined as a residual hematic pleural effusion larger than 500 mL after 72 h of treatment with a thoracic tube. The aim of this study is to investigate risk factors for the development of RH in thoracic trauma and predictors of surgery. A retrospective, observational, monocentric study was conducted in a Trauma Hub Hospital in Milan, recording thoracic trauma from January 2011 to December 2020. Pre-hospital peripheric oxygen saturation (SpO2) was significantly lower in the RH group (94% vs. 97%, p = 0.018). Multivariable logistic regression analysis identified, as independent predictors of RH, sternum fracture (OR 7.96, 95% CI 1.16-54.79; p = 0.035), pre-admission desaturation (OR 0.96; 95% CI 0.77-0.96; p = 0.009) and the number of thoracic tube maintenance days (OR 1.22; 95% CI 1.09-1.37; p = 0.0005). The number of tubes placed and the 1° rib fracture were both significantly associated with the necessity of surgical treatment of RH (2 vs. 1, p = 0.004; 40% vs. 0%; p = 0.001). The risk of developing an RH in thoracic trauma should not be underestimated. Variables related to RH must be taken into account in order to schedule a proper follow-up after trauma.
摘要：
胸部创伤发生在全世界所有创伤患者中的20-25%，是创伤相关死亡的第三大原因。保留血胸（RH）定义为在用胸管治疗72小时后，残留的血性胸腔积液大于500mL。这项研究的目的是调查胸部创伤中RH发展的危险因素和手术的预测因素。回顾，观察,单中心研究是在米兰的创伤中心医院进行的，记录2011年1月至2020年12月的胸部创伤。RH组的院前外周血氧饱和度（SpO2）显着降低（94％vs.97%,p=0.018)。多变量逻辑回归分析确定，作为RH的独立预测因子，胸骨骨折（OR7.96，95％CI1.16-54.79；p=0.035），入院前饱和度下降(OR0.96;95%CI0.77-0.96;p=0.009)和胸管维持天数(OR1.22;95%CI1.09-1.37;p=0.0005)。置管数量和1°肋骨骨折均与RH手术治疗的必要性显着相关（2vs.1，p=0.004；40%vs.0%；p=0.001）。不应低估胸部创伤中发生RH的风险。必须考虑与RH相关的变量，以便安排创伤后的适当随访。
