Abstract
Background Emergency thoracotomy (ET) is a critical intervention for traumatic thoracic injuries, often required in patients with penetrating trauma. The survival outcomes and the factors that influence survival in these patients remain an area of interest for trauma care providers. Objective The objective of the study is to assess the survival rate and factors influencing the survival of patients undergoing emergency thoracotomy due to penetrating thoracic trauma. Methods This retrospective cross-sectional study was conducted in the thoracic surgery, accident, and emergency department of Lady Reading Hospital, Peshawar, Pakistan. A total of 85 patients who underwent emergency thoracotomy following penetrating trauma between July 2019 and June 2024 were included. Data were extracted from the health information management system (HIMS) and analyzed using SPSS. The study reviewed demographic details, severity of injury, operative details, and postoperative outcomes. Statistical analyses included univariate analysis using chi-square and Fisher's exact tests for categorical data and independent t-tests for continuous variables. Results The study included 85 patients with a mean age of 25.72±7.84 years. The majority of patients were male (81/85, 95.29%), while females accounted for a smaller proportion (4/85, 4.71%), and gunshot trauma accounted for the most frequent cause of penetrating injury (50/85, 58.8%). The time to thoracotomy was within 60 minutes of admission, with a mean time of 48±16.5 minutes. A total of 61/85 (71.5%) patients had isolated thoracic injuries, and 24/85 (28.2%) had associated injuries, with 24/85 (28.2%) patients requiring concomitant laparotomy. The overall mortality rate was 9/85 (10.5%), with 7/9 (77.7%) of deaths occurring intraoperatively. Mortality was significantly higher in patients with combined thoracotomy and laparotomy procedures. Prolonged hospital stays and higher transfusion requirements were observed in gunshot wound victims (50/85, 58.8%). Conclusions Emergency thoracotomy for penetrating thoracic trauma has a significant mortality rate in patients with combined thoracic and abdominal injuries. Factors such as the mechanism of injury, associated injuries, and the need for additional procedures (e.g., laparotomy) influence survival outcomes. Early intervention and proper management of associated injuries are crucial for improving survival rates in these patients.