Mokhtar, Mohd Faris
(2014)
Retrospective review of chest trauma in
Hospital Universiti Sains Malaysia over 10-year
period.
Masters thesis, Universiti Sains Malaysia.
Abstract
BACKGROUND: Chest trauma is an important trauma globally accounting for about
10% of trauma admission and 25% of trauma death. Different types and severity of
chest trauma in different subsets of patients with varying associated injuries result in
different outcomes.
OBJECTIVE: To study the pattern, aetiology, management, and outcome of chest
trauma in Hospital Universiti Sains Malaysia (HUSM) over 10-year period from
January 2003 till December 2012.
METHODS: This is a 10-year retrospective study, which was conducted in HUSM
from January 2003 till December 2012. It involved 504 patients who were admitted to
surgical ward HUSM during the study period. The hospitalization criteria include
intra-thoracic injury and clinically significant rib cage injury. Exclusion criteria for
this study include patients who arrived dead in the emergency room, patients who did
not complete their treatment in our hospital, isolated laryngeal or spinal injuries,
oesophageal and tracheal injuries due to foreign body swallowing or aspirating and
non-traumatic injuries to the chest (burns, electrical shocks, etc). The data was
retrieved from medical record and analyzed concerning age, gender, comorbid,
mechanism and aetiology of the trauma, thoracic and extra-thoracic injuries, intensive
care unit (ICU) admission, mechanical ventilation, management, hospital length of
stay (LOS) and mortality.
RESULTS: A total of 504 patients met the inclusion criteria, where 412 were males
(82.0%). The most frequent aetiology was road traffic accident (RTA) (425 cases;
84.3%). The most frequent type of chest trauma was rib fracture (384 cases; 76.2%).
The risk for associated intrathoracic injuries increased significantly as the number of
rib fracture increase. There were 11 (2.2%) thoracotomies performed during the study
period where 8 of them were caused by penetrating injury. Overall hospital length of
stay (LOS) ranged from 1-94 days with mean of 10.2 days (SD=12.4). Mortality was
observed in 35 patients (6.9%). Associated extrathoracic injuries, ICU admission and
ventilation requirement were significantly affect hospital LOS and mortality.
CONCLUSIONS: RTA is the main cause of chest trauma in Kelantan. The number of
rib fractures more than 5 is a good indicator of the severity of the injury. Presence of
extrathoracic injuries, ICU admission and ventilation requirement have been found to
be a good predictors for outcome of chest trauma.
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