{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T09:29:21Z","timestamp":1784366961312,"version":"3.55.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T00:00:00Z","timestamp":1632787200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Pulmonary contusions (PCs) have historically been viewed as a serious complicating factor in thoracic injury. Recently, there has been conflicting evidence regarding the influence of PCs on outcomes; however, many studies do not stratify contusions by severity and may miss clinical associations. We sought to identify if contusion severity is associated with worse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A previously published chest wall injury database at an urban Level I trauma center was retrospectively reviewed. All severely injured subjects (defined as Injury Severity Score [ISS] \u2265 15) with moderate to severe thoracic injury (defined as a chest wall Abbreviated Injury Scale [AIS] \u2265 3) who required mechanical ventilation for &gt; 24 h were stratified by contusion severity. Moderate to severe contusions were defined as AIS contusion \u2265 3 and Blunt Pulmonary Contusion 18 (BPC18) score \u2265 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Over 5 y, 3,836 patients presented with chest wall injuries, of which 1,176 (30.6%) had concomitant contusions. When screened for inclusion criteria, 339 subjects with contusions and 211 subjects without contusions (no-PC) were identified. Of these, 234 had moderate to severe contusions defined by AIS contusion \u2265 3 (PC-A) and 230 had moderate to severe contusions by BPC18 \u2265 3 (PC-B). Compared to no-PC, both PC-A and PC-B groups had significantly lower mortality (17.9% and 17.4%, respectively, vs 28.9%); however, PC-A and PC-B groups had longer durations of mechanical ventilation (6 and 7 d, respectively, vs 5 d), longer ICU length of stay (10 and 10 vs 8 d), and longer overall hospital length of stay (15 and 15 vs 13 d).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In severely injured polytrauma patients, PCs are seen with more severe chest injuries. Furthermore, moderate to severe contusions are associated with longer durations of mechanical ventilation, ICU length of stay, and hospital length of stay. Despite practice pattern changes, contusions appear to contribute significantly to the clinical course of the blunt chest wall injured patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.09145","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T14:58:09Z","timestamp":1632841089000},"page":"1665-1672","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["The Association Between Pulmonary Contusion Severity and Respiratory Failure"],"prefix":"10.1177","volume":"66","author":[{"given":"S Whitney","family":"Zingg","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Cincinnati, Cincinnati, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D A","family":"Millar","sequence":"additional","affiliation":[{"name":"Divisions of Trauma, University of Cincinnati Medical Center and West Chester Hospital Trauma, Cincinnati, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D","family":"Goodman","sequence":"additional","affiliation":[{"name":"Divisions of Trauma, University of Cincinnati Medical Center and West Chester Hospital Trauma, Cincinnati, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy A","family":"Pritts","sequence":"additional","affiliation":[{"name":"Divisions of Trauma, University of Cincinnati Medical Center and West Chester Hospital Trauma, Cincinnati, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher F","family":"Janowak","sequence":"additional","affiliation":[{"name":"Divisions of Trauma, University of Cincinnati Medical Center and West Chester Hospital Trauma, Cincinnati, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,9,28]]},"reference":[{"issue":"4","key":"e_1_3_3_2_2","first-page":"323","article-title":"Acute respiratory distress syndrome incidence, but not mortality, has decreased nationwide: a national trauma data bank study","volume":"83","author":"Fahr M","year":"2017","unstructured":"Fahr M, , Jones G, , O'Neal H, , Duchesne J, , Tatum D. Acute respiratory distress syndrome incidence, but not mortality, has decreased nationwide: a national trauma data bank study. Ann Surg, 2017; 83(4):323-331.","journal-title":"Ann Surg"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-014-0052-4"},{"issue":"6","key":"e_1_3_3_4_2","first-page":"1543","article-title":"Blunt pulmonary contusion: admission computed tomography scan predicts mechanical ventilation","volume":"71","author":"De Moya MA","year":"2011","unstructured":"De Moya MA, , Manolakaki D, , Chang Y, , Amygdalos I, , Gao F, , Alam HB, et al. Blunt pulmonary contusion: admission computed tomography scan predicts mechanical ventilation. J Trauma, 2011; 71(6):1543-1547.","journal-title":"J Trauma"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31827019fd"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313480206801002"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1751143718767060"},{"issue":"1","key":"e_1_3_3_8_2","first-page":"1","article-title":"Nationwide cohort study of independent risk factors for acute respiratory distress syndrome after trauma","volume":"4","author":"Tignanelli CJ","year":"2019","unstructured":"Tignanelli CJ, , Hemmila MR, , Rogers MA, , Raghavendran K. Nationwide cohort study of independent risk factors for acute respiratory distress syndrome after trauma. Trauma Surg Acute Care, 2019; 4(1):1-9.","journal-title":"Trauma Surg Acute Care"},{"issue":"1","key":"e_1_3_3_9_2","first-page":"7","article-title":"Lung Contusions: a clinicopathological entity with unpredictable clinical course","volume":"1","author":"Ganie FA","year":"2013","unstructured":"Ganie FA, , Lone H, , Lone GN, et al. Lung Contusions: a clinicopathological entity with unpredictable clinical course. Bull Emerg Trauma, 2013; 1(1):7-16.","journal-title":"Bull Emerg Trauma"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.11.043"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-017-0384-y"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05952"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-007-7027-3"},{"key":"e_1_3_3_14_2","volume-title":"The Abbreviated Injury Scale 2005 Update 2008","author":"Gennarelli TA","year":"2008","unstructured":"Thorax. In: Gennarelli TA, , Wodzin E. eds. The Abbreviated Injury Scale 2005 Update 2008. Association for the Advancement of Automotive Medicine; 2008."},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199905000-00011"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002390"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2019.01.027"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.06388"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.4187\/respcare.09145","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.09145","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.09145","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T08:56:22Z","timestamp":1775465782000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4187\/respcare.09145"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,28]]},"references-count":17,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.4187\/respcare.09145"],"URL":"https:\/\/doi.org\/10.4187\/respcare.09145","relation":{},"ISSN":["0020-1324"],"issn-type":[{"value":"0020-1324","type":"print"}],"subject":[],"published":{"date-parts":[[2021,9,28]]}}}