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Profile of chest trauma in a level I trauma center

Pankaj Kulshrestha1, Imtiaz Munshi, Richard Wait

  • 1Department of Surgery, Baystate Medical Center, Springfield, Massachusetts, USA.

The Journal of Trauma
|September 30, 2004
PubMed

Insights

Chest trauma incidence is rising. Low Glasgow Coma Scale score and advanced age are key predictors of mortality in chest injury patients, with most cases managed non-surgically.

Area of Science:

  • Trauma Surgery
  • Emergency Medicine
  • Critical Care

Background:

  • Chest injuries are increasingly prevalent in urban hospitals.
  • The specific characteristics of chest trauma vary by hospital size and trauma center level.
  • Limited data exists on the true incidence of chest trauma.

Purpose of the Study:

  • To analyze the incidence, treatment, and outcomes of chest trauma.
  • To identify independent predictors of mortality following chest trauma.

Main Methods:

  • Prospective data collection on 1359 consecutive patients at a Level I trauma center.
  • Retrospective analysis of injury nature, treatment, morbidity, and mortality.
  • Multiple logistic regression to determine mortality predictors.

Main Results:

  • Overall mortality rate was 9.41%.
  • Independent predictors of mortality included low Glasgow Coma Scale score, advanced age, penetrating chest injury, long bone fractures, multiple rib fractures (>5), and liver/spleen injuries.
  • A predictive model for mortality was developed.

Conclusions:

  • Most chest injuries require only observation; tube thoracostomy (18.32%) and thoracotomy (2.6%) are less common.
  • Low Glasgow Coma Scale score and advanced age are the most significant independent predictors of mortality.
Abstract

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