Evaluation of Risk Factors in Thoracic Trauma Patient at a Tertiary Care Hospital
Keywords:
Thoracic trauma, ; Rib Fracture, Blunt Chest Trauma, Flail ChestAbstract
Background: One of the most frequent injuries in the emergency room is thoracic trauma. They range from penetrating chest injuries to blunt chest injuries. To improve the prognosis, quick medical and surgical measures are required. The present study was conducted to evaluate the pattern of thoracic trauma presenting to the emergency room, its outcome, and the risk factors contributing to it. Methodology: This prospective observational study was carried out at the Department of General Surgery / Thoracic Surgery Hayatabad Medical Complex Peshawar from January 2020 to January 2021. A total of 60 patients with thoracic trauma were included in the study. The mean ISS score was 38. Age, concomitant diseases, presence of pneumothorax and/or hemothorax, the need for mechanical support, length of stay, and deaths were evaluated by using the t-test and x2 test where appropriate. Results: Â There were 35 (58.3%) patients with blunt traumas and 25 (41.7%) patients with penetrating traumas. Among penetrating trauma, the most common injury was gunshot 12 (48%), followed by stab wounds 8 (32%), and occupational injuries 5 (20%). Among blunt traumas, road traffic accidents RTAs 20 (57.1%) were frequently identified, followed by falls from height 9 (25.7%), assault 4 (11.4%), and occupational injuries 2 (5.7%). Mechanical ventilation was needed in 17 (28.3%) patients, diagnosis at the time of admission was, hemothorax 22 (36.7%), rib fractures were seen in 16 (26.7%), 12 (20%) patients with abdominal injuries, and 10 (16.7%) with a head injury. Conclusions: Age and hemopneumothorax did not affect mortality. Mechanical support was not considered a necessity for the treatment of thoracic trauma patients. ÂReferences
Aghaei Afshar M, Mangeli F, Nakhaei A. Evaluation of injuries caused by penetrating chest traumas in patients referred to the emergency room. Indian J Surg. 2015; 77:191-4. DOI: 10.1007/s12262-012-0757-4
Shulzhenko NO, Zens TJ, Beems MV, et al. Number of rib fractures thresholds independently predict worse outcomes in older patients with blunt trauma. Surgery. 2017; 161:1083-9. DOI: 10.1016/j. surg.2016.10.018
Al-Koudmani I, Darwish B, Al-Kateb K, Taifour Y. Chest trauma experience over eleven-year period at Almouassat University Teaching hospital-Damascus: a retrospective review of 888 cases. J Cardiothorac Surg. 2012; 7:35. DOI: 10.1186/1749-8090-7-35
El-Menyar A, Abdelrahman H, Al-Hassani A, et al. Clinical presentation and time-based mortality in patients with chest injuries associated with road traffic accidents. Arch Trauma Res. 2016; 5:31888. DOI: 10.5812/atr.31888.
Kumar BA, Chakravarthy GR, Bharath A. Blunt trauma chest: a study on clinical pattern . J Dent Med Sci. 2017; 16:1-7. 10.9790/0853-1603070107
Swan Jr KG, Swan BC, Swan KG. Decelerational thoracic injury. J Trauma 2001;51(5):970 – 4.
Freedland M, Wilson RF, Bender JS, Levison MA. The management of flail chest: factors affecting outcome. J Trauma 1990;1460 – 8.
Albaugh G, Kann B, Puc MM, Vemulapalli P, Marra S, Ross S. Age- adjusted out comes in traumatic flail chest injuries in the elderly. Am Surg 2000;66:978 –81.
Ziegler DW, Agarwal NN. The morbidity and mortality of rib fractures. J Trauma 1994;37(6):975 – 9.
Velmahos GC, Vassiliu P, Chan LS, Murray JA, Berne TV, Demetriades D. Influence of flail chest on
outcome among patients with severe thoracic cage trauma. Int Surg 2002;87(4):240 – 4.
Johnson JA, Cogbill TH, Winga ER. Determinants of outcome after pulmonary contusion. J Trauma
;17(5):322 – 6.
Dimopoulou I, Anthi A, Lignos M, Boukouvals E, Evangelou E, Routsi Ch, Mandragos K, Roussos Ch.
Prediction of prolonged ventilatory support. Intens Care Med 2003;29(7):1101 – 5.
Lardinois D, Krueger T, Dusmet M, Ghisletta N, Gugger M, Ris HB. Pulmonary function testing after
operative stabilization of the chest wall for flail chest. Eur J Cardiothorac Surg 2001;20(3): 496 – 501.
Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Shimazaki S. Surgical stabilization or internal
pneumatic stabilization? a prospec- tive randomized study of management of severe flail chest patients. J
Trauma 2002;52(4):727 – 32.
Khan K, Jamil M, Memon IA, Idrees Z: Pattern of injuries in motorbike accidents . J Pak Orthop Assoc.
, 30:123-127.
Sirmali M, Turut H, Topcu S, Gulhan E, Yazic U, Kaya S, Tastepe I. A comprehensive analysis of traumatic
rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg 2003;24:133– 8.
Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S. Chest injury due to blunt trauma. Eur J Cardiothorac
Surg 2003;23:374– 8.
Lema MK, Chalya PL, Mabula JB, Mahalu W. Pattern and outcome of chest injuries at Bugando Medical
Centre in Northwestern Tanzania. J Cardiothorac Surg. 2011, 6:7. DOI: 10.1186/1749-8090-6-7
Çakmak M, Kandemir MN. Study of 433 operated cases of thoracic trauma. Indian J Surg. 2016, 78:477-81. DOI: 10.1007/s12262-015-1414-5
Simon B, Ebert J, Bokhari F. Management of pulmonary contusion and flail chest: an Eastern
Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012, 73:351-61. DOI: 10.1097/TA.0b013e31827019fd.
Huber S, Biberthaler P, Delhey P. Predictors of poor outcomes after significant chest trauma in
multiply injured patients: a retrospective analysis from the German Trauma Registry (Trauma Register
Scand J Trauma Resus Emerg Med. 2014, 22:52. DOI: 10.1186/s13049-014-0052-4.
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