Thoracic injury: a review of 276 cases

Chest injury, one of the most important aspects of trauma, directly accounts for 25% of all trauma-related deaths and plays a major contributing role in another 25% of trauma deaths. This paper aimed to explore the spectrum and outcome of thoracic injuries seen in a multi centric study of trauma patients.

A total of 276 consecutive trauma patients in 6 general hospitals were analyzed. The feature of injury, injury severity score (ISS), clinical treatment and mortality were recorded in a prospective manner and analyzed retrospectively. Multiple logistic regression analysis was used to determine the independent predictors of mortality following the chest trauma.

There were 246 males (89.1%) and 30 females (10.9%) ranging from 3 to 80 years with a mean age of (34+/-17) years. Road traffic accident was the main cause of injury, especially for pedestrians, followed by stab wound (89 cases, 32.1%) and falling injuries (32 cases, 11.6%), respectively. Haemothorax or pneumothorax (50.4%) and rib fracture (38.6%) were the most common types of chest injury. Extremity fracture was the most common associated injury with the rate of 37% ( 85/230), followed by head injury (25.2%) and abdominal trauma (19.6%). These injuries contributed significantly to the morbidity and mortality of trauma patients.

According to the results, most patients with chest injury can be treated conservatively with close observation and tube thoracostomy. The presence of blunt trauma, head injury and abdominal injury independently adversely affect mortality after chest trauma. It is necessary to investigate the causes and patterns of injuries resulting from stab wound for effective prevention.