To study the etiology, pattern and short term...

To study the etiology, pattern and short term outcome of chest injuries as prospective study

Author Name : Dr. M.S. Griwan, Dr. Suresh Kumar, Dr. Naresh Pal

ABSTRACT
Introduction: Chest injuries still are a continuing challenge to the trauma to the general surgeon practicing in developing countries. This study was conducted to define the etiological spectrum, injury patterns and short term outcome of these injuries in our institute.

Material and methods: This was a prospective study in one hundreds patients of chest injury between the age group 15-80 yrs with GCS 15/15, admitted in Pt. BD Sharma Postgraduate Institute of Medical Science, Rohtak over a period of one and quarter of a year period from August 2014 to November 2015.

Results: A total of 100 chest injury patients were included and found that the males were affected predominantly in comparison of female in ratio of 7.3:1. The included age was from 15 to 80 years (mean = 32.17 years). The 59% patients were having the causative factor of road side accident (being the commonest cause) and 96% injuries caused by Blunt including road side accidents (RSAs), fall from height, assaults or by animals. The rib fractures were found 87% was commonest nature of chest injury as all over. The pneumothorax, haemothorax, haemopneumothorax and lung contusions were found in 76%, 42% 28% and 51% respectively. 56.0% of patients were found along associated co-existing injuries in the form of head and neck (33.3%) and orthopedic (26.7%) and abdominal injuries. All of the patients were treated successfully with conservatively approach with minor procedure tube thoracostomy in 67%. Four patients were operated as exploratory laparotomy for associated abdominal injury; two of them were injured by penetrating injury of stab chest with abdominal component. The mean LOS was 5.6 days which was increased in case of associated injuries and it was maximum of fifteen days in one of the patient had tracheobronchial injury which was managed conservatively with negative suction underseal water drainage. Two patients were managed in respiratory intensive care unit (RICU) out of four with flail chest injuries patients.
Conclusion: RSAs was commonest cause in chest injuries which was responsible for the majority of morbidity and associated increased the Length of stay and overall impact of chest injury in our institute. The motorcycle was commonest vehicle (34 patients out of 59 patients of RSAs) found involved in RSAs followed by fall from height under influence of alcohol. Authority should be strict to implement the traffic laws and issue the driving permission after appropriate training to reduce the at least unwanted RSAs.