Clinical Characteristics of Pulmonary Contusion in Trauma Patients and Determinants of Mortality: A Retrospective Analysis

Aim: Pulmonary contusion is a leading cause of morbidity and mortality in trauma patients. This study retrospectively evaluated the clinical characteristics of patients with pulmonary contusion who presented to the emergency department, as well as the factors associated with mortality. Materials and Methods: This retrospective, cross-sectional study included patients aged 18 years and older who were diagnosed with pulmonary contusion by computed tomography and who presented to the emergency department of a tertiary university hospital between 2019 and 2024. The analysis included demographic characteristics, trauma mechanism, associated injuries, including by body region, laboratory parameters, complications, treatment approaches, and clinical outcomes. Results: A total of 350 patients were evaluated; mean age was 47.8±18.6 years, and 79.4% were male. The most common trauma mechanism was blunt trauma. Pulmonary contusion was most frequently observed in the lower lobes. The most prevalent associated injuries were rib fractures, pneumothorax, and hemothorax. The 30-day total mortality rate was 8%. Among non-survivors, the following were significantly higher: age, chest trauma scores, complication rates, lactate levels, and pCO2 levels. Conclusion: In trauma patients, pulmonary contusion most frequently occurs in the lower lobes and commonly accompanies chest wall and pleural injuries. Advanced age, a higher chest trauma score, the development of complications, and elevated lactate and pCO2 levels are risk factors for mortality. Early evaluation of these parameters may facilitate prompt identification of high-risk cases.