Akademik Veri Yönetim Sistemi
Updates in Surgery, 2026 (SCI-Expanded, Scopus)
Pulmonary contusion is a common consequence of thoracic trauma and is associated with respiratory compromise and increased intensive care demand. However, prognostic determinants in these patients remain incompletely defined. This study aimed to identify clinical and laboratory predictors of in-hospital mortality among trauma patients with pulmonary contusion. We retrospectively analyzed 355 adult trauma patients with pulmonary contusion confirmed by thoracic CT. Demographic, clinical, and laboratory variables were compared between survivors and non-survivors. The Injury Severity Score (ISS) was calculated, and an optimal cut-off was identified using ROC analysis. Independent predictors of mortality were determined using a parsimonious multivariate logistic regression model restricted to clinically relevant and non-collinear variables. The mean age of the cohort was 41.0 ± 17.1 years, and most patients were male (86.5%). Blunt trauma accounted for 86.5% of injuries. Mechanical ventilation was required in 36.3%, and 39.4% were admitted to the ICU. Overall in-hospital mortality was 5.1% (n = 18). In the multivariate model, age (adjusted OR 1.04; 95% CI 1.001–1.079; p = 0.043), ISS > 22 (adjusted OR 5.75; 95% CI 1.43–23.13; p = 0.014), and serum bicarbonate < 18.8 mmol/L (adjusted OR for survival 0.05; 95% CI 0.01–0.17; p < 0.001) remained independent predictors of mortality. Age, admission bicarbonate level, and overall injury severity are independent predictors of in-hospital mortality in thoracic trauma patients with pulmonary contusion. Combining a readily available metabolic marker with global injury severity scoring may enhance early risk stratification and guide clinical decision-making.