{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T06:36:21Z","timestamp":1794033381505,"version":"4.8.0"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,1,5]],"date-time":"2018-01-05T00:00:00Z","timestamp":1515110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2018,1,5]],"date-time":"2018-01-05T00:00:00Z","timestamp":1515110400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Major blunt chest injury usually leads to the development of retained hemothorax and pneumothorax, and needs further intervention. However, since blunt chest injury may be combined with blunt head injury that typically requires patient observation for 3\u20134\u00a0days, other critical surgical interventions may be delayed. The purpose of this study is to analyze the outcomes of head injury patients who received early, versus delayed thoracic surgeries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>From May 2005 to February 2012, 61 patients with major blunt injuries to the chest and head were prospectively enrolled. These patients had an intracranial hemorrhage without indications of craniotomy. All the patients received video\u2010assisted thoracoscopic surgery (VATS) due to retained hemothorax or pneumothorax. Patients were divided into two groups according to the time from trauma to operation, this being within 4\u00a0days for Group 1 and more than 4\u00a0days for Group 2. The clinical outcomes included hospital length of stay (LOS), intensive care unit (ICU) LOS, infection rates, and the time period of ventilator use and chest tube intubation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>All demographics, including age, gender, and trauma severity between the two groups showed no statistical differences. The average time from trauma to operation was 5.8\u00a0days. The ventilator usage period, the hospital and ICU length of stay were longer in Group 2 (6.77 vs. 18.55, <jats:italic>p<\/jats:italic> = 0.016; 20.63 vs. 35.13, <jats:italic>p<\/jats:italic> = 0.003; 8.97 vs. 17.65, <jats:italic>p<\/jats:italic> = 0.035). The rates of positive microbial cultures in pleural effusion collected during VATS were higher in Group 2 (6.7 vs. 29.0%, <jats:italic>p<\/jats:italic> = 0.043). The Glasgow Coma Scale score for all patients improved when patients were discharged (11.74 vs. 14.10, <jats:italic>p<\/jats:italic> &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>In this study, early VATS could be performed safely in brain hemorrhage patients without indication of surgical decompression. The clinical outcomes were much better in patients receiving early intervention within 4\u00a0days after trauma.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-4420-x","type":"journal-article","created":{"date-parts":[[2018,1,5]],"date-time":"2018-01-05T15:47:30Z","timestamp":1515167250000},"page":"2061-2066","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Early Management of Retained Hemothorax in Blunt Head and Chest Trauma"],"prefix":"10.1002","volume":"42","author":[{"given":"Fong\u2010Dee","family":"Huang","sequence":"first","affiliation":[{"name":"Division of Trauma, Department of Emergency Kaohsiung Veterans General Hospital 386, Da\u2010Chung 1st Road 813 Kaohsiung City Taiwan"},{"name":"Department of Kinesiology, Health, and Leisure Studies National University of Kaohsiung Kaohsiung City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Bin","family":"Yeh","sequence":"additional","affiliation":[{"name":"Division of Trauma, Department of Emergency Kaohsiung Veterans General Hospital 386, Da\u2010Chung 1st Road 813 Kaohsiung City Taiwan"},{"name":"Department of Nursing Kaomei Junior College of Health Care and Management Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng\u2010Shih","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Trauma, Department of Emergency Kaohsiung Veterans General Hospital 386, Da\u2010Chung 1st Road 813 Kaohsiung City Taiwan"},{"name":"Department of Optometry Shu\u2010Zen Junior College of Medicine and Management Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan\u2010Yuarn","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Trauma, Department of Emergency Kaohsiung Veterans General Hospital 386, Da\u2010Chung 1st Road 813 Kaohsiung City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u2010Yin","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Trauma, Department of Emergency Kaohsiung Veterans General Hospital 386, Da\u2010Chung 1st Road 813 Kaohsiung City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Pin","family":"Chou","sequence":"additional","affiliation":[{"name":"Division of Trauma, Department of Emergency Kaohsiung Veterans General Hospital 386, Da\u2010Chung 1st Road 813 Kaohsiung City Taiwan"},{"name":"Department of Cosmetic Science, College of Human Ecology Chang Gung University of Science and Technology Kweishan, Taoyuan Taiwan"},{"name":"Division of Thoracic Surgery, Department of Surgery Kaohsiung Veterans General Hospital Kaohsiung City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzu\u2010Chin","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Chest Medicine, Department of Internal Medicine Chung Shan Medical University Hospital Taichung Taiwan"},{"name":"School of Medicine Chung Shan Medical University Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,5]]},"reference":[{"issue":"1","key":"e_1_2_7_2_2","first-page":"S1","article-title":"Guidelines for the management of severe traumatic brain injury","volume":"24","author":"Brain Trauma Foundation","year":"2007","journal-title":"J Neurotrauma"},{"issue":"2086","key":"e_1_2_7_3_2","first-page":"5","article-title":"Prevention of secondary ischemic insults after severe head injury","volume":"27","author":"Robertson CS","year":"1999","journal-title":"Crit Care 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