Danbot: Complete article rewrite

2026-03-21T22:59:08Z

Complete article rewrite

← Older revision		Revision as of 22:59, 21 March 2026
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	~~PMID~~ 9680018		{{JC info
			\| title= Survival After Emergency Department Thoracotomy: Review of Published Data From the Past 25 Years
			\| abbreviation= ED Thoracotomy
			\| expansion=
			\| published= 1998
			\| author= Rhee PM, Acosta J, Bridgeman A, Wang D, Jordan M, Rich N.
			\| journal= J Am Coll Surg
			\| year= 2000
			\| volume= 190
			\| issue= 3
			\| pages= 288-298
			\| pmid= 9680018
			\| fulltexturl=
			\| pdfurl=
			\| status = Complete
			}}

			==Clinical Question==
			What are the survival rates and indications for emergency department thoracotomy (EDT), and which patient populations are most likely to benefit?

			==Conclusion==
			*EDT is most effective in penetrating cardiac injuries with witnessed vital signs
			*Overall survival after EDT is approximately 7.4%, but varies significantly by mechanism and patient presentation
			*Patients with penetrating cardiac injuries who arrive with signs of life have the highest survival rates (up to 35%)
			*EDT for blunt trauma has extremely poor outcomes (<2% survival) and should rarely be performed

			==Major Points==
			*This was the most comprehensive review of EDT outcomes at the time, analyzing over 7,000 patients from 42 studies
			*Survival by mechanism: penetrating cardiac injuries 19.4%, penetrating non-cardiac thoracic 10.7%, penetrating abdominal/extremity 4.5%, blunt trauma 1.4%
			*Signs of life (pupillary response, spontaneous ventilation, cardiac electrical activity) at presentation predict better outcomes
			*The study established evidence-based guidelines for when EDT should and should not be performed
			*EDT is futile in patients without vital signs after blunt trauma with >10 minutes of prehospital CPR

			==Study Design==
			*Systematic review of published literature on emergency department thoracotomy
			*42 studies reviewed spanning 25 years of published data
			*N = 7,035 patients who underwent EDT

			==Population==
			===Inclusion Criteria===
			*Published studies reporting outcomes of emergency department thoracotomy
			*Studies with sufficient data to calculate survival rates by mechanism
			===Exclusion Criteria===
			*Case reports with insufficient outcome data
			*Studies combining EDT with OR thoracotomy without separating outcomes

			==Interventions==
			*Emergency department thoracotomy (left anterolateral thoracotomy)
			*Goals of EDT: release pericardial tamponade, control cardiac hemorrhage, cross-clamp aorta for hemorrhage control, internal cardiac massage

			==Outcomes==
			===Primary Outcome===
			*Overall survival to discharge: 7.4% (521/7,035)
			===Secondary Outcomes===
			*Survival by mechanism:
			**Penetrating cardiac: 19.4%
			**Penetrating non-cardiac thoracic: 10.7%
			**Penetrating abdominal: 4.5%
			**Blunt trauma: 1.4%
			*Neurologically intact survival: majority of survivors had good neurological outcomes

			==Criticisms==
			*Significant heterogeneity across studies in patient selection, technique, and outcome definitions
			*Publication bias may overestimate survival rates (centers with better outcomes more likely to publish)
			*Review included older studies with different prehospital care standards
			*Definition of "signs of life" varied across studies
			*Does not address the resource utilization or cost-effectiveness of EDT

			==Funding==
			*None reported

			==See Also==
			*[[Emergency department thoracotomy]]
			*[[Penetrating chest trauma]]
			*[[Cardiac tamponade]]

			==References==
			<references/>

	[[Category:EBQ]]		[[Category:EBQ]]
			[[Category:Trauma]]

Rossdonaldson1 at 22:33, 1 December 2013

2013-12-01T22:33:04Z

← Older revision		Revision as of 22:33, 1 December 2013
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	PMID 9680018		PMID 9680018

			[[Category:EBQ]]

Rossdonaldson1: Rossdonaldson1 moved page Effective ED Thoracotomy Usage to EBQ:Effective ED Thoracotomy Usage

2013-12-01T22:32:57Z

Rossdonaldson1 moved page Effective ED Thoracotomy Usage to EBQ:Effective ED Thoracotomy Usage

← Older revision	Revision as of 22:32, 1 December 2013
(No difference)

Ostermayer: Created page with "PMID 9680018"

2013-11-13T06:25:09Z

Created page with "PMID 9680018"

New page

PMID 9680018

EBQ:Effective ED Thoracotomy Usage - Revision history

Danbot: Complete article rewrite

Rossdonaldson1 at 22:33, 1 December 2013

Rossdonaldson1: Rossdonaldson1 moved page Effective ED Thoracotomy Usage to EBQ:Effective ED Thoracotomy Usage

Ostermayer: Created page with "PMID 9680018"