Evidence map›Paper›PMID 42643763›Full record

ArticleTrauma surgery & acute care open2026

Thoracic damage control: association of complications and mortality.

Matthew Vasquez, Patrick Walker, David V Feliciano, Thomas M Scalea, James V O'Connor

Abstract read
In one paragraph

Article in Trauma surgery & acute care open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Matthew VasquezProgram in Trauma, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.ORCID https://orcid.org/0009-0005-7917-9406
Patrick WalkerProgram in Trauma, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0002-0871-2702
David V FelicianoProgram in Trauma, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.
Thomas M ScaleaProgram in Trauma, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.
James V O'ConnorProgram in Trauma, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Thoracic damage control (TDC) is an operative strategy for physiologically depleted patients with severe thoracic injuries. The relationship of TDC complications and mortality has not been comprehensively examined. This study analyzed the association of complications and mortality following TDC. Methods: A retrospective registry review at a Level 1 trauma center identified patients ≥16 years undergoing TDC. Demographics, physiological data, injuries, operations, complications, and mortality were abstracted. Univariate and multivariate analyses for mortality risk factors were performed. Results: A total of 98 patients met the inclusion criteria. The median age was 31 (23-44) years, 52% male, and 69% had penetrating trauma. The median Injury Severity Score (ISS) was 32 (26-41), chest Abbreviated Injury Scale 4 (4-5), admission systolic blood pressure 112 (77-138), pH 7.16 (6.99-7.25), base deficit -11 (-17 to -7), and lactate 8.1 (5.7-11.3). The operative procedures performed included pulmonary 63.5%, cardiac 29.6%, great vessels 16.2%, and 66.3% had a concomitant damage control laparotomy. Of the entire cohort, 72 (73.5%) patients developed at least one complication, including bacteremia 35%, renal failure requiring continuous renal replacement therapy (CRRT) 23%, pneumonia 18%, and empyema 12%. Mortality was 25.5% (25/98), with 72% (18/25) occurring prior to chest closure. Univariate analysis demonstrated that blunt trauma (p<0.001), male sex (p=0.006), lower pH (p=0.007), higher ISS (p<0.001), and CRRT (p=0.031) were statistically significant risk factors for mortality. On multivariate analysis, only blunt trauma (OR 3.82, 95% CI 1.1 to 13.3, p=0.035) and admission pH <7.1 (OR 3.13, 95% CI 1.03 to 9.5, p=0.044) were independently associated with mortality. Conclusion: TDC is an essential operative strategy in patients with severe thoracic injuries presenting in advanced shock. Both blunt trauma and degree of shock are independent risk factors for mortality, which are present on admission. Although complications are frequent and severe, they do not predict mortality. Level of evidence: IV, diagnostic test/criteria.

Indexed as

complicationsmortalityThoracic InjuriesThoracic Surgical Procedures

Identifiers

PMID42643763
PMCPMC13504910

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.