Abstract
PROFILE OF TRAUMATIC CHEST INJURY PRESENTING TO TERTIARY CARE CENTRE IN EASTERN NEPAL

Rupesh Prasad Sah*, Keshav Raj Pandey, Aawish Bhandari, Abhijeet Kumar, Lokesh Shekhar Jaiswal and Rakesh Kumar Gupta

ABSTRACT

Background: Chest injury is a major public health problem and is associated with a high risk of mortality. Respiratory complications may necessitate prolonged ventilation and result in death. The chest injury has become a major bulk of trauma cases presenting to our center. Therefore, we studied epidemiological profile and treatment outcomes of these patients presenting to our hospital. Patients and Methods: We reviewed our experience with 164 patients with blunt chest injuries who were admitted over a 2-year period from January 2016 to December 2017. We recorded demographic profile, mode of injury, associated injury commonly managed by surgical or conservative methods the frequency and the pattern of chest injury patients, duration of hospital admission, injury mechanism, ventilator support requirement, associated injuries, ICU days, total length of stay (LOS), outcomes, prevalence and incidence of different chest injury patients. Results: Mean hospitalization time was 8.03 days Eleven patients (6.7%) were admitted in the ICU and the mean length of stay was 6 days. 95.2% patients were improved and discharged, 3.0% were referred and 1.8% expired. Out of 164 patients, 38(23.2%) patients received conservative analgesia and tube thoracostomy was done in 137(83.5%) patients. Eight patients were managed with other thoracic procedures and 15(9.1%) were not intervened. Four patients (2.4%) had undergone Open thoracotomy. The number of rib fractures was significantly related with the presence of hemothorax or pneumothorax. Conclusion: Thoracic injury is common injury in patients with fall from height and Road traffic accidents. Achieving better results in the treatment of patients with chest wall injury depend on a variety of factors. In case of associated extra thoracic injury, multidisciplinary approach is essential for good outcome. Urgent preventive measures targeting at reducing the occurrence of fall injury and road traffic accident is necessary to reduce the incidence of chest injuries.

Keywords: Blunt trauma; Chest injury; Rib fracture, Hemothorax.


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