Survival predictor in emergency resuscitative thoracotomy for blunt trauma patients: Insights from a Chinese trauma center.

Shan LIU; Lin LING; Yong FU; Wen-Chao ZHANG; Yong-Hu ZHANG; Qing LI; Liang ZENG; Jun HU; Yong LUO; Wen-Jie LIU

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Survival predictor in emergency resuscitative thoracotomy for blunt trauma patients: Insights from a Chinese trauma center.

Author: Shan LIU ¹ ; Lin LING ² ; Yong FU ³ ; Wen-Chao ZHANG ¹ ; Yong-Hu ZHANG ¹ ; Qing LI ¹ ; Liang ZENG ¹ ; Jun HU ⁴ ; Yong LUO ⁵ ; Wen-Jie LIU ^{6
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Author Information

1. Department of Emergency, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan province, China.
2. The Second Affiliated Hospital, National Regional Key Cities and Sub-central Cities in Hunan Province Hengyang Academician and Expert International Academic Exchange High Tech University, Building A First-class Discipline for Trauma and Critical Care, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan province, China.
3. Department of Pediatric Orthopedics and Hand & Foot Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan province, China.
4. Department of Cardiovascular Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China.
5. Department of Emergency, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan province, China. Electronic address: 2009020013@usc.edu.cn.
6. The Second Affiliated Hospital, National Regional Key Cities and Sub-central Cities in Hunan Province Hengyang Academician and Expert International Academic Exchange High Tech University, Building A First-class Discipline for Trauma and Critical Care, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan province, China; Department of Anesthesiology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan province, China. Electronic address: wenjieliu96@
7. com.
Publication Type:Journal Article
Keywords: Blunt trauma; Cardiac tamponade; Emergency resuscitative thoracotomy; Survivor predictors
MeSH: Adult; Female; Humans; Male; Middle Aged; Case-Control Studies; China; Logistic Models; Resuscitation/mortality*; Retrospective Studies; Survival Rate; Thoracotomy/methods*; Trauma Centers/statistics & numerical data*; Wounds, Nonpenetrating/surgery*
From: Chinese Journal of Traumatology 2025;28(4):288-293
CountryChina
Language:English
Abstract: PURPOSE:Emergency resuscitative thoracotomy (ERT) is a final salvage procedure for critically injured trauma patients. Given its low success rate and ambiguous indications, its use in blunt trauma scenarios remains highly debated. Consequently, our study seeks to ascertain the overall survival rate of ERT in blunt trauma patients and determine which patients would benefit most from this procedure.
METHODS:A retrospective case-control study was conducted for this research. Blunt trauma patients who underwent ERT between January 2020 and December 2023 in our trauma center were selected for analysis, with the endpoint outcome being in-hospital survival, divided into survival and non-survival groups. Inter-group comparisons were conducted using Chi-square and Fisher's exact tests, the Kruskal-Wallis test, Student's t-test, or the Mann-Whitney U test. Univariate and multivariate logistic regression analyses were conducted to assess potential predictors of survival. Then, the efficacy of the predictors was assessed through sensitivity and specificity analysis.
RESULTS:A total of 33 patients were included in the study, with 4 survivors (12.12%). Multivariate logistic regression analysis indicated a significant association between cardiac tamponade and survival, with an adjusted odds ratio of 33.4 (95% CI: 1.31 - 850.00, p = 0.034). Additionally, an analysis of sensitivity and specificity, targeting cardiac tamponade as an indicator for survivor identification, showed a sensitivity rate of 75.0% and a specificity rate of 96.6%.
CONCLUSION:The survival rate among blunt trauma patients undergoing ERT exceeds traditional expectations, suggesting that select individuals with blunt trauma can significantly benefit from the procedure. Notably, those presenting with cardiac tamponade are identified as the subgroup most likely to derive substantial benefits from ERT.