Penetrating Thoracic Injuries: a Retrospective Analysis from a French Military Trauma Centre ; Traumatismes thoraciques pénétrants : analyse rétrospective de 69 cas civils et militaires pris en charge dans un centre de traumatologie français

Introduction: Penetrating Thoracic Injuries (PTIs) are a medico-surgical challenge for trauma teams. Few european studies focus on the specificity of PTIs. The aim of this study was to analyse the demographic, injury patterns, surgical management and clinical outcomes of civilian and military patients who were admitted to a French Military Teaching Hospital with PTIs over a twelve-year period. Patients and methods: all patients with PTIs admitted to a Level I Trauma Centre and to Role-2 facilities in war theatres between January 1, 2004 and May 31, 2016 were included. Results: a total of 69 patients were included, of whom 17 were military casualties. Mechanisms of injury were first stabwounds for civilian patients (63%), gunshotwounds (59%) and shrapnel (41%) for military casualties. NISS was 35,6 ± 13,5 for military casualties, 21,2 ± 12,2 for civils. 29 (33%) patients were unstable or in cardiac arrest on admission. 30 (43%) were transfused. 38 (55%) patients had thoracic surgery, 25 thoracotomy were performed. 13 thoracoscopies were performed in stable patients. Intra-hospital mortality was 18,8%. Conclusion: an anticipated medico-surgical and protocol approach must allow the effective management of severe and hemorrhagic patients who require frequent recourse to surgery. ; Introduction : les Traumatismes Thoraciques Pénétrants (TTP) sont un challenge médico-chirurgical pour les équipes de traumatologie. Il existe peu de données européennes publiées s’y intéressant. Le but de l’étude était d’analyser les critères démographiques, les mécanismes lésionnels, la prise en charge médico-chirurgicale et la morbimortalité de patients militaires et civils, pris en charge dans un Hôpital d’Instruction des Armées (HIA) sur une période de 12 ans. Patients et méthodes : tous les patients présentant un TTP admis à l’HIA Percy et en rôle 2 en opération extérieure entre le 1er janvier 2004 et le 31 mai 2016 ont été inclus. Résultats : soixante-neuf patients ont été inclus, dont 17 patients militaires. Les mécanismes ...