Classification and management of chest trauma.
OBJECTIVE
To classify the predominant pattern of injuries following blunt and penetrating chest trauma and to assess the adequacy of treatment strategies, complications and mortality associated with such injuries.


METHODS
Descriptive study.


METHODS
Surgical Unit I, Holy Family Hospital, Rawalpindi, from December 2000 to December 2003.


METHODS
One hundred consecutive patients with thoracic trauma either blunt or penetrating, admitted in the ward were evaluated. Their injuries were classified, treatment strategies outlined and complications and mortality were documented on a specially-designed proforma.


RESULTS
Out of the 100 patients presenting in emergency, 44% presented with blunt and 56% with penetrating trauma. Pneumothorax was detected in 39% of the patients, hemopneumothorax in 29%, hemothorax in 12%, flail chest in 9 %. Two had involvement of the heart and major vessels, 4 % had injury to the diaphragm and 5 % had multiple trauma. During treatment, 3% of all the patients were managed conservatively, 83% of patients required chest intubations, 6% needed ventilatory support and 8 % required thoracotomy. Complications were experienced in 28% of the patients of which 9% had pneumonias, 14% empyema and 5 % suffered from wound infections. The overall mortality was 7 %.


CONCLUSIONS
This series showed the pattern of injuries following blunt and penetrating chest trauma. Furthermore, it was found that chest intubation and simple resuscitation was adequate for majority of the cases.
Farooq
Umar
U
Surgical Unit-I, Holy Family Hospital, Rawalpindi. umars100@hotmail.com
Raza
Waqas
W
Zia
Naeem
N
Hanif
Mohammad
M
Khan
Mohammad Mussadiq
MM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D013898:Thoracic Injuries / Q000145:classification* / Q000401:mortality / Q000628:therapy*; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000145:classification / Q000401:mortality / Q000628:therapy; D014950:Wounds, Penetrating / Q000145:classification / Q000401:mortality / Q000628:therapy