EXPERIENCE WITH CHEST TRAUMA: ANALYSIS OF 400 CASES

INTRODUCTION There is an increase in traumatic chest injuries in the present days due to increase in road traffic accidents and violence in various forms. Chest trauma cases are usually associated with other injuries also. The most common being head injury, which also incidentally is the most common cause of death in many patients. Complete evaluation of the patient and early intervention can reduce the mortality and morbidity. AIMS To analyse 400 consecutive cases of chest trauma based on the cause of injury, the type of injury, associated injuries and method of intervention. MATERIALS AND METHODS The present study is a prospective study. All the cases referred to the Department of Cardiothoracic Surgery, which required hospital admission and intervention were selected for the study. RESULTS The total number of cases with injuries registered in our hospital in two and a half years were 45,341 out of which 400 cases (0.88%) were traumatic chest injuries. There were 374 (93.5%) adults and 26 (6.5%) children. There were 379 (94.7%) males and only 21 (5.2%) females. Male patients were more as compared to females, the ratio being 18:1. Maximum number of cases 135 (93.7%) were seen in the 21-30 years age group followed by the 31-40 years age group, 110 (27.5%) cases. The mode of trauma was blunt injury in 364 (91%) cases and penetrating type of injury in 36 (9%) cases. The causes of chest trauma were road traffic accidents in 187 cases (46.7%), violence in 170 cases (42.5%) and miscellaneous causes in 52 cases (13%). Associated injuries observed were 265 cases (66.5%) cases. The most common was head injury seen in 73 cases (18.2%) cases. Intervention was done in 331 cases (82.75%). Out of 400 cases, 22 cases (5.5%) had death. CONCLUSIONS Motor vehicle accidents are the most common cause of traumatic chest injuries. Early arrival to the hospital improves the chances of survival. Patients already in shock at the time of arrival to hospital have poor prognosis