Prevalence of chest trauma, associated injuries and mortality: a level I trauma centre experience

Abstract

A review of prospectively collected data in our trauma unit for the years 1998-2003 was undertaken. Adult patients who suffered multiple trauma with an Injury Severity Score (ISS) of ≥16, admitted to hospital for more than 72 hours and with sustained blunt chest injuries were included in the study. Demographic details including prehospital care, trauma history, admission vital signs, blood transfusions, details of injuries and their abbreviated injury scores (AIS), operations, length of intensive care unit and hospital stays, Injury Severity Score (ISS) and mortality were analysed. Fulfilling the inclusion criteria with at least one chest injury were 1,164 patients. The overall mortality reached 18.7%. As expected, patients in the higher AIS groups had both a higher overall ISS and mortality rate with one significant exception; patients with minor chest injuries (AIS chest =1) were associated with mortality comparable to injuries involving an AIS chest =3. Additionally, the vast majority of polytraumatised patients with an AIS chest =1 died in ICU sooner than patients of groups 2-5.

Blunt Thoracic Injury Mortality and Clinical Presentation

“…Veysi's review study also revealed that the most common injury was single or multiple rib fracture, lung contusion, and pneumothorax, respectively (6). Mortality rate in this study was 1.5% and the highest rate was observed within the first 24 hours post-trauma.…”

“…A review of blunt chest trauma supports this finding. Veysi review results indicated that the major reasons for blunt chest trauma were traffic accidents with an incidence of 57.1%, while pedestrians, drivers, motorcyclists, respectively, were most injured (6). Therefore, reduction of road accidents should be considered as the first priority in public health planning.…”

“…Blunt thoracic trauma, most commonly involved the younger population and was usually related to road traffic accidents (RTA) (6,(20)(21)(22). Based on the present study results, the most common mechanisms of blunt thoracic injury was car accidents (40.5%).…”

“…Thoracic trauma is the third most frequent injury after head and extremities in patients with multiple trauma (5). In addition, approximately 0.06% of disability cases per year are caused by chest trauma (6). Blunt thoracic injuries are the third most common injury in poly-trauma patients following head and extremities trauma (7).…”

“…Thoracic injuries cover the spectrum from trivial to lethal, and more than half of them are associated with head, abdomen, or extremity trauma (6,15). Therefore, proper evaluation of thoracic injury complications could prevent delayed treatment consequences and reduce mortality and morbidity rates (17,18).…”