DOI: http://dx.doi.org/10.18203/2349-2902.isj20202561

Clinical study of patients with trauma to the chest in a tertiary care centre

Vijay D. Potey, Karan D. Kale, Vijay B. Kanake

Abstract


Background: Chest trauma is one of the serious injuries and also one of the leading causes of death from physical trauma. Current study is designed to study clinical profile, pattern of injuries, complications and treatment modality required in chest trauma management.

Methods: A prospective observational study was conducted in Shri Vasantrao Naik Government Medical College, a tertiary care hospital in Yavatmal, Maharashtra, India in 246 patients primarily admitted for chest trauma from 1st March 2018 to 31st August 2019.  All cases were managed in emergency department with history noted, clinical examination performed and initial management done as per ATLS guidelines. Definitive management done according to clinical and radiological investigations. Final outcome (death/discharge) was noted with discharged patients were followed until normal activity regained.

Results: Male of 3rd-4th decade constituted most vulnerable group, with mean age of 38.56 years and male:female ratio of 5.31:1. Road traffic accident (RTA) was the commonest cause (71.14%), followed by assault (11.79%) and accidental fall (11.38%). Blunt force was the most common mechanism (93.09%).  Rib fracture was present in 26.83%, lung contusion in 8.13% patients, followed by haemothorax (7.32%), hemopneumothorax (5.70%) and pneumothorax (3.25%). Conservative management suffices in most cases (86.59%), tube thoracostomy in 12.19%, thoracotomy in 1.22% cases. Patients with VAS score of 6 and above required intercostal nerve block (5.31%) or epidural analgesia (2.45%) for satisfactory pain relief. Pneumonia and atelectasis were common complications 2.03% each. Mortality rate was 1.22%. Average length of hospital stay was 4.6 days.

Conclusions: Chest trauma commonly affects young males with RTA causing significant morbidity and mortality. Majority of patients can be treated conservatively.   

 


Keywords


Chest trauma, Thoracotomy, Intercostal nerve block, Tube thoracostomy

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References


Wilson RF, Murray C, Antonenko DR. Nonpenetrating thoracic injuries. Surg Clin North Am. 1977;69:15-9.

Kulshrestha P, Iyer KS, Das B, Balram A, Sampath Kumar A, Sharma ML, et al. Chest injuries: A clinical and autopsy profile. J Trauma Inj Infect Crit Care. 1988;28(6):844-7.

Shorr RM, Crittenden M, Indeck M, Hartunian SL, Rodriguez A. Blunt thoracic trauma, analysis of 515 patients. Ann Surg. 1987;206(2):200-5.

West JG, Trunkey DD, Lim RC. Systems of trauma care: a study of two counties. Arch Surg. 1979;114(4):455-60.

Kumar DBA, Chakravarthy DGR, Bharath DA. Blunt Trauma Chest: A Study on Clinical Pattern. IOSR J Dent Med Sci. 2017;31(4):315-20.

Shah JV, Solanki MI. Analytic Study of Chest Injury. IJSS J Surg. 2015;1(1):5-9.

Dalal S, Nityesha M, Vashisht MDR. Prevalence of chest trauma at an apex institute of North India: a retrospective study. Intern J Surg. 2008;18(1):23-30.

Dangi SK, Meena N, Parmar A. A prospective study of chest injuries and associated complications with special reference to surgical emphysema. Int Surg J. 2018;57:17-36.

Sharma K, Tated PS, Hatkar AA. Study of the pattern and management of blunt chest injuries in rural setup. Int Surg J. 2017;4(10):3482-7.