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

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.