Chest trauma experience over eleven-year period at al-mouassat university teaching hospital-Damascus: a retrospective review of 888 cases

Alkoudmani, Ibrahim; Darwish, Bassam; Al-Kateb, Kamal; Taifour, Yahia

doi:10.1186/1749-8090-7-35

Cited by 65 publications

(54 citation statements)

References 16 publications

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“…These incidences are consistent with reports suggesting a 10–15% incidence of chest injuries among trauma patients [12], [13]. At the same time, most chest injuries in our patients were minor or moderate and resolved after conservative treatment, as reported in other major earthquakes [2], [3], [14].…”

Section: Discussionsupporting

confidence: 93%

Retrospective Cohort Analysis of Chest Injury Characteristics and Concurrent Injuries in Patients Admitted to Hospital in the Wenchuan and Lushan Earthquakes in Sichuan, China

Zheng

Yao

et al. 2014

PLoS ONE

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BackgroundThe aim of this study was to compare retrospectively the characteristics of chest injuries and frequencies of other, concurrent injuries in patients after earthquakes of different seismic intensity.MethodsWe compared the cause, type, and body location of chest injuries as well as the frequencies of other, concurrent injuries in patients admitted to our hospital after the Wenchuan and Lushan earthquakes in Sichuan, China. We explored possible relationships between seismic intensity and the causes and types of injuries, and we assessed the ability of the Injury Severity Score, New Injury Severity Score, and Chest Injury Index to predict respiratory failure in chest injury patients.ResultsThe incidence of chest injuries was 9.9% in the stronger Wenchuan earthquake and 22.2% in the less intensive Lushan earthquake. The most frequent cause of chest injuries in both earthquakes was being accidentally struck. Injuries due to falls were less prevalent in the stronger Wenchuan earthquake, while injuries due to burial were more prevalent. The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types. Spinal and head injuries concurrent with chest injuries were more prevalent in the less violent Lushan earthquake. All three trauma scoring systems showed poor ability to predict respiratory failure in patients with earthquake-related chest injuries.ConclusionsPrevious studies may have underestimated the incidence of chest injury in violent earthquakes. The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity. Earthquake severity and interval between rescue and treatment may influence the prevalence and types of injuries that co-occur with the chest injury. Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake-related chest injuries.

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Section: Discussionsupporting

confidence: 93%

Retrospective Cohort Analysis of Chest Injury Characteristics and Concurrent Injuries in Patients Admitted to Hospital in the Wenchuan and Lushan Earthquakes in Sichuan, China

Zheng

Yao

et al. 2014

PLoS ONE

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“…Previous studies have shown that thoracic trauma cases with accompanying head trauma had greater mortality rates than those without it. [24,25] In this study, only 30 (5.6%) cases had isolated thoracic trauma. Of the patients in this study with accompanying traumas, only those with accompanying CNS trauma had significantly higher mortality rates.…”

Section: Discussionmentioning

confidence: 55%

Predictors Of Mortality In Cases With Thoracic Trauma Admitted To The Intensive Care Unit: 10-Year Clinical Outcomes

Küçük

Küçük²,

Aksoy³

et al. 2018

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:Multiple traumas are a leading cause of mortality among young adults worldwide. Thoracic trauma causes approximately 25% of all trauma-associated deaths. This study aims to determine the independent prognostic factors of mortality in cases with thoracic trauma (isolated or with accompanying organ injuries) who were admitted to the intensive care unit (ICU). METHODS:We retrospectively reviewed data from patients with thoracic trauma who were admitted to our ICU between 2007 and 2016. After excluding pediatric patients (aged <18 years), the study sample included 564 cases. From the records, we collected the patients' demographical data, comorbid diseases, primary trauma as an indication for ICU admission, other traumas accompanying thoracic trauma, type of thoracic injury, and therapeutic interventions. The study sample was divided into two subsets: survival and non-survival groups. These two groups were compared with regards to first ICU day laboratory results and intensive care scores, mechanical ventilation times, and ICU stay lengths. RESULTS:Of the 8063 patients admitted to the ICU between 2007 and 2016, 616 (7.6%) had thoracic trauma. The median age (min-max) of the 564 patients eligible for this study was 43 (18-87) years. Mortality occurred in 159 (28.1%) cases, while 405 (71.8%) were discharged from the ICU. Multivariate regression analyses were also performed, in which every increment in age was associated with a 1.025-fold increase in the odds of mortality due to thoracic trauma. Additionally, the presence of central nervous system (CNS) trauma was associated with a 2.147-fold increase, and the presence of pulmonary contusion was associated with a 1.752-fold increase. CONCLUSION:Results of this study indicate that advanced age, the presence of pulmonary contusion, and accompanying CNS trauma are independent predictors of mortality in patients with thoracic trauma in the ICU. Our non-invasive approach is further supported by the trauma and injury severity score (TRISS) scoring system, which is one of the latest scoring systems used in trauma cases.

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“…Most rib fracture cases (69%) are associated with other thoracic injuries mainly hemo/pneumothorax and lung contusion, 5% of which diagnosed after 24 hours of trauma (15). In our study, a chest tube was inserted in 70.7%, mostly due to pneumothorax, hemothorax, or hemopneumothorax.…”

Section: Discussionmentioning

confidence: 58%

Clinical Analysis of the Correlation Between Rib Fractures and Prognosis in Multiple Trauma Patients

Hashemzadeh¹,

Kermani²,

Kakaei³

et al. 2018

Trauma Mon

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Background: Thoracic trauma is an important cause of morbidity and mortality in trauma patients and rib fracture due to blunt trauma to the chest wall is the most common etiology. Objectives: This study analyzed the correlation between rib fractures and prognosis in multiple trauma patients. Methods: One hundred eighty-four trauma patients suffering from rib fracture due to the blunt trauma were studied. Demographic data, injury characteristics, rib fracture characteristics, the associated injuries, and injury severity score (ISS) were recorded. The rib fracture was classified according to location (left, right, and bilateral) and level (upper [1st -2nd rib], middle [3rd -8th rib], and lower [9th -12th rib]); it also was categorized as lateral and posterolateral. Results: The rib fractures were posterolateral (69.6%), lateral (30.4%), upper (4.3%), middle (92.4%), and lower (3.3%). Patients with posterolateral fracture had significantly more complications leading to airway intubation and more intensive care support, higher ISS, associated with pelvic and clavicular fracture. Upper rib fractures were associated with more length-of-stay (LOS) while lower rib fractures were associated more with abdominal trauma and lumbar/thoracolumbar vertebral fractures. A significant positive correlation was seen between the number of fractured ribs and ISS, hospital, and ICU LOS. There were no complications during a two-month follow-up. Conclusions: Upper rib fractures are associated with severe traumas requiring more hospitalization and ICU support due to the more surgical and medical complications. Morbidity is higher in posterolateral fractures and these patients need more medical care.

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Chest trauma experience over eleven-year period at al-mouassat university teaching hospital-Damascus: a retrospective review of 888 cases

Cited by 65 publications

References 16 publications

Retrospective Cohort Analysis of Chest Injury Characteristics and Concurrent Injuries in Patients Admitted to Hospital in the Wenchuan and Lushan Earthquakes in Sichuan, China

Retrospective Cohort Analysis of Chest Injury Characteristics and Concurrent Injuries in Patients Admitted to Hospital in the Wenchuan and Lushan Earthquakes in Sichuan, China

Predictors Of Mortality In Cases With Thoracic Trauma Admitted To The Intensive Care Unit: 10-Year Clinical Outcomes

Clinical Analysis of the Correlation Between Rib Fractures and Prognosis in Multiple Trauma Patients

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