Pattern and presentation of blunt chest trauma among different age groups

We assessed the presentation and mechanisms of blunt chest injuries sustained in different age groups, and the impact on management options. We retrospectively reviewed the records of 486 patients with blunt chest trauma who were treated between 2004 and 2007. They were stratified into 3 age groups: pediatric, adult, and elderly. Clinical data, mechanism of injury, associated injuries, treatment strategies, and mortality were analyzed. The majority of patients were male (86%), and the largest age group was 12-60-years old (79%). Motor vehicle accidents accounted for 93% of cases. Isolated chest injuries were more common than combined injuries (69% vs. 31%). Tube thoracostomy was required in 39% of patients, predominantly in the elderly age group. Combined injuries involved bone fractures (21%), head (5%), and abdominal trauma (5%). Most blunt chest injuries were treated conservatively (95.5%). Open thoracotomy was required in 4.5% for clotted hemothorax (3.7%), empyema (0.6%), and massive air leak (0.2%). Mortality was 1%, predominantly in the adult group (0.8%). Blunt thoracic injuries are a major cause of morbidity and mortality. As the majority of such injuries are related to motor vehicle accidents, preventative strategies should be enforced.