409 The impact of inadequate pain control following chest trauma on hospital acquired pneumonia rate and hospital admission length

Abstract

Introduction Patients with blunt chest wall injuries often have severe associated injuries and even isolated chest injuries may have a high mortality and morbidity. The National Audit Office (2010) report estimated that there are 20,000 cases of major trauma per year in England; 5,400 people die of their injuries with many others sustaining permanent disability. Aim To assess compliance with trust guidelines for chest trauma pathway and the impact of poorly controlled pain on hospital acquired pneumonia (HAP) rate and hospital admission length Method A retrospective audit of all chest trauma between October 2019 to February 2020. Data obtained from electronic patient records and admission notes. Patients notes and imaging records are used to analyse adequate pain control based on local chest trauma pathways. Results 28 patients identified (M:F 15:13) aged 47-94 yrs old (average age 73) who suffered from chest trauma in a district general hospital in England. Chest trauma was associated with high levels of morbidity (32%) and mortality (7%). 39% of patients were found to have inadequate pain control based on the local chest trauma pathway. 33% of chest trauma patients developed a HAP and 44% of pts with inadequate pain control developed a HAP. The admission length of patients with HAP secondary to chest trauma was on average three times longer relative to uncomplicated patients (15 days vs 5 days). Conclusions Chest trauma patients often receive inadequate pain control and delayed specialist team input. This results in an increase in the frequency of HAPs and admission length.