94 Table 7 Mean systolic blood pressure and standard deviation in the different types of injuries *ANOVA: p=0.000 Type of injury Car crash Motorbike crash Pedestrian-vehicle collisions Falls Bicycle accidents Gunshots Stabbings Fights Non-intentional wounds Impaling, electric shock, suicide Patients 91 46 22 76 22 18 41 24 13 17 Int J Emerg Med (2010) 3:91–95 Mean 117.58 114.57 112.73 125.00 122.73 75.00 118.54 131.25 125.82 125.38 Standard deviation 40.92 36.62 57.91 34.89 37.44 60.32* 33.36 19.63 13.19 12.66 There were no significant differences between blunt and penetrating traumas in respect to discharge after the initial evaluation, hospitalization and death (chi-square test: p = 0.3, Table 8). Moreover, there were no significant differ- ences between blunt and penetrating injuries in respect to the trauma indexes, blood pressure, pulse and respiration rate. Discussion This study shows that loss of consciousness is a risk factor that affects the prognosis of patients that suffer thoracic injuries whether associated with other types of injury or not. Patients who lost consciousness were more frequently hospitalized and died in the hospital, thereby demonstrating the greater severity of the clinical status with a relative risk of 9.7. In this study, the evaluation of the loss of consciousness was made between the scene of the accident and the patient’s arrival in the emergency room, and so this is simple and rapid information that may be used as a warning sign for prognosis. These observations associating thoracic injury with loss of consciousness were not found in publications linked to PubMed, Scopus, ISI, ATLS (Ad- vanced Trauma Life Support) and Scielo, and so provide Table 8 Blunt and penetrating traumas in respect to outcome (discharge after the initial evaluation, hospitalization and death) Penetrating Blunt Total 42 84 126 Chi-square test: p=0.306 Quick discharge Hospitalization Death Total Conclusion 79 118 197 13 30 43 134 232 366 new information for the thoracic surgeon in respect to the severity of wounds. In this study, 47 patients arrived at the hospital with blood pressure that was unrecordable, which affected the state of consciousness of these patients. Brain injuries were another important aspect in this study; 175 patients had an AIS ≥4. Thus, the severity of this type of injury may contribute to the percentage of patients who lose consciousness. The pre-hospital triage policy might have impacted the outcome as the ambulance service trans- ports the more severely ill patients directly to a trauma reference center and the less severely ill patients to other smaller centers. Although this was not an objective of the current study, the time from the ambulance service arriving at the scene of the accident to the patient arriving at hospital was quick and similar for all patients. This policy may contribute to the access of more severely ill patients, those who probably would have died if the ambulance service was not specialized, to specialized treatment. Thoracic injury is a significant cause of mortality, and identification of factors involved in the trauma are important [14]. In the current study, loss of conscious- ness was identified as yet another aggravating factor in thoracic injuries. The type of accident influenced the outcomes in this study; loss of consciousness is associ- ated with car crashes and pedestrian-vehicle collisions; however, stab wounds are not associated with loss of consciousness. Loss of consciousness evaluated at the time of the injury is a warning sign about the severity of thoracic injuries of patients whether associated with other types of injuries or not.