Contemporary assessment of laryngotracheal trauma

Rehal A. Bhojani, David H. Rosenbaum, Erkan Dikmen, Michelle Paul, B. Zane Atkins, David Zonies, Aaron S. Estrera, Michael A Wait, Dan M Meyer, Michael E Jessen, J. Michael DiMaio

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Objectives: Laryngotracheal trauma is a rare and potentially deadly spectrum of injuries. We sought to characterize the contemporary mechanisms, diagnostic modalities, and outcomes common in laryngotracheal trauma today. Methods: We performed a retrospective analysis of all laryngotracheal trauma cases at 2 major metropolitan hospitals between 1996 and 2004, detailing mechanisms, associated injuries, diagnostic modalities, and outcomes of laryngotracheal trauma. Results: We identified 71 patients with a mean age of 32.8 ± 13.3 years (range, 15-71 years). In our series penetrating trauma was the cause in 73.2% of patients; however, blunt trauma had a significantly higher mortality (63.2% vs 13.5%, respectively; P < .0001). Blunt mechanisms involved older patients (38.5 ± 15.2 years vs 30.1 ± 11.9 years, P = .017), and these patients were more likely to require emergency airways than those with penetrating trauma (78.9% vs 46.2%, P = .017). The requirement of an emergency airway was an independent predictor of mortality (P = .0066). Conclusion: Laryngotracheal trauma is a deadly spectrum of injuries with a mortality of 26.8%. Blunt mechanisms are decreasing in frequency. This might reflect improvements in automobile safety. Additionally, violent crime is on the increase, producing penetrating injuries with increasing frequency. The most fundamental intervention for patients with laryngotracheal injury is airway control. Either routine intubation or a tracheostomy can secure the airway. Blunt trauma and the requirement of an emergency airway are independent predictors of mortality. Laryngotracheal trauma requires prompt recognition, airway protection, and skillful management to lessen the mortality of this deadly spectrum of injuries.

Original languageEnglish (US)
Pages (from-to)426-432
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume130
Issue number2
DOIs
StatePublished - Aug 2005

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Wounds and Injuries
Mortality
Emergencies
Automobiles
Airway Management
Tracheostomy
Urban Hospitals
Crime
Intubation
Safety

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Bhojani, R. A., Rosenbaum, D. H., Dikmen, E., Paul, M., Atkins, B. Z., Zonies, D., ... DiMaio, J. M. (2005). Contemporary assessment of laryngotracheal trauma. Journal of Thoracic and Cardiovascular Surgery, 130(2), 426-432. https://doi.org/10.1016/j.jtcvs.2004.12.020

Contemporary assessment of laryngotracheal trauma. / Bhojani, Rehal A.; Rosenbaum, David H.; Dikmen, Erkan; Paul, Michelle; Atkins, B. Zane; Zonies, David; Estrera, Aaron S.; Wait, Michael A; Meyer, Dan M; Jessen, Michael E; DiMaio, J. Michael.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 130, No. 2, 08.2005, p. 426-432.

Research output: Contribution to journalArticle

Bhojani, RA, Rosenbaum, DH, Dikmen, E, Paul, M, Atkins, BZ, Zonies, D, Estrera, AS, Wait, MA, Meyer, DM, Jessen, ME & DiMaio, JM 2005, 'Contemporary assessment of laryngotracheal trauma', Journal of Thoracic and Cardiovascular Surgery, vol. 130, no. 2, pp. 426-432. https://doi.org/10.1016/j.jtcvs.2004.12.020
Bhojani RA, Rosenbaum DH, Dikmen E, Paul M, Atkins BZ, Zonies D et al. Contemporary assessment of laryngotracheal trauma. Journal of Thoracic and Cardiovascular Surgery. 2005 Aug;130(2):426-432. https://doi.org/10.1016/j.jtcvs.2004.12.020
Bhojani, Rehal A. ; Rosenbaum, David H. ; Dikmen, Erkan ; Paul, Michelle ; Atkins, B. Zane ; Zonies, David ; Estrera, Aaron S. ; Wait, Michael A ; Meyer, Dan M ; Jessen, Michael E ; DiMaio, J. Michael. / Contemporary assessment of laryngotracheal trauma. In: Journal of Thoracic and Cardiovascular Surgery. 2005 ; Vol. 130, No. 2. pp. 426-432.
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abstract = "Objectives: Laryngotracheal trauma is a rare and potentially deadly spectrum of injuries. We sought to characterize the contemporary mechanisms, diagnostic modalities, and outcomes common in laryngotracheal trauma today. Methods: We performed a retrospective analysis of all laryngotracheal trauma cases at 2 major metropolitan hospitals between 1996 and 2004, detailing mechanisms, associated injuries, diagnostic modalities, and outcomes of laryngotracheal trauma. Results: We identified 71 patients with a mean age of 32.8 ± 13.3 years (range, 15-71 years). In our series penetrating trauma was the cause in 73.2{\%} of patients; however, blunt trauma had a significantly higher mortality (63.2{\%} vs 13.5{\%}, respectively; P < .0001). Blunt mechanisms involved older patients (38.5 ± 15.2 years vs 30.1 ± 11.9 years, P = .017), and these patients were more likely to require emergency airways than those with penetrating trauma (78.9{\%} vs 46.2{\%}, P = .017). The requirement of an emergency airway was an independent predictor of mortality (P = .0066). Conclusion: Laryngotracheal trauma is a deadly spectrum of injuries with a mortality of 26.8{\%}. Blunt mechanisms are decreasing in frequency. This might reflect improvements in automobile safety. Additionally, violent crime is on the increase, producing penetrating injuries with increasing frequency. The most fundamental intervention for patients with laryngotracheal injury is airway control. Either routine intubation or a tracheostomy can secure the airway. Blunt trauma and the requirement of an emergency airway are independent predictors of mortality. Laryngotracheal trauma requires prompt recognition, airway protection, and skillful management to lessen the mortality of this deadly spectrum of injuries.",
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AU - Zonies, David

AU - Estrera, Aaron S.

AU - Wait, Michael A

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AU - Jessen, Michael E

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N2 - Objectives: Laryngotracheal trauma is a rare and potentially deadly spectrum of injuries. We sought to characterize the contemporary mechanisms, diagnostic modalities, and outcomes common in laryngotracheal trauma today. Methods: We performed a retrospective analysis of all laryngotracheal trauma cases at 2 major metropolitan hospitals between 1996 and 2004, detailing mechanisms, associated injuries, diagnostic modalities, and outcomes of laryngotracheal trauma. Results: We identified 71 patients with a mean age of 32.8 ± 13.3 years (range, 15-71 years). In our series penetrating trauma was the cause in 73.2% of patients; however, blunt trauma had a significantly higher mortality (63.2% vs 13.5%, respectively; P < .0001). Blunt mechanisms involved older patients (38.5 ± 15.2 years vs 30.1 ± 11.9 years, P = .017), and these patients were more likely to require emergency airways than those with penetrating trauma (78.9% vs 46.2%, P = .017). The requirement of an emergency airway was an independent predictor of mortality (P = .0066). Conclusion: Laryngotracheal trauma is a deadly spectrum of injuries with a mortality of 26.8%. Blunt mechanisms are decreasing in frequency. This might reflect improvements in automobile safety. Additionally, violent crime is on the increase, producing penetrating injuries with increasing frequency. The most fundamental intervention for patients with laryngotracheal injury is airway control. Either routine intubation or a tracheostomy can secure the airway. Blunt trauma and the requirement of an emergency airway are independent predictors of mortality. Laryngotracheal trauma requires prompt recognition, airway protection, and skillful management to lessen the mortality of this deadly spectrum of injuries.

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