Epidemiology of Chest Trauma in Kashan Trauma Centers

Abstract

Background: Trauma is the most common cause of death between the ages of 1 and 44. Chest trauma as a potentially life threatening injury is increasing with increased number of high-speed accidents in Iran. Materials and Methods: 282 patients were treated for chest trauma in our center between March 2003 and September 2007. Data including the patients' age and gender, blood pressure, respiratory rate on admission, Glasgow Coma Scale (GCS) scores, Revised Trauma Score, types of trauma, the extent of intra thoracic injury, types of associated injuries, length of hospital and ICU stay, morbid conditions, and deaths were recorded and analyzed. Results: 237 patients were male (84%), and 45 female (16%). Mean age was 37.67±19.14 with the age range of 6 months to 84 years. 222 patients (78.7%) had blunt and 60 (21.3%) penetrating chest trauma. Motorcycles and car accidents were the most common etiologic causes in 167 (59.3%). Rib fracture was the most common thoracic injury with 178 (63%) and pelvic and limb injuries the most frequent extra-thoracic injury with 93 (33%). Seventy percent of patients were treated with either closed thoracostomy drainage or clinical observation while 71 (25%) needed surgical intervention during the first 24 hours. The most common operation was laparotomy. Mean duration of hospital stay was 7± 9.6 (range: 1-70) and ICU stay 1.9days. Out of 282 patients overall mortality was 33 (11.7%) and pulmonary infection 12 (4.2%). Conclusion: Chest trauma is a major preventable cause of mortality and morbidity in our country. Systolic blood pressure ≤90, pulse rate ≥120, respiratory rate >29, GCS <8 at the time of admission, and blunt type of trauma were found as the predictors of mortality and morbidity