title: Thoracic Injuries in earthquake-related versus non-earthquake-related trauma patients: differentiation via Multi-detector Computed Tomography.
abstract: OBJECTIVE
  Massive earthquakes are harmful to humankind. This study of a historical cohort aimed to investigate the difference between earthquake-related crush thoracic traumas and thoracic traumas unrelated to earthquakes using a multi-detector Computed Tomography (CT).
  
  
  METHODS
  We retrospectively compared an earthquake-exposed cohort of 215 thoracic trauma crush victims of the Sichuan earthquake to a cohort of 215 non-earthquake-related thoracic trauma patients, focusing on the lesions and coexisting injuries to the thoracic cage and the pulmonary parenchyma and pleura using a multi-detector CT.
  
  
  RESULTS
  The incidence of rib fracture was elevated in the earthquake-exposed cohort (143 vs. 66 patients in the non-earthquake-exposed cohort, Risk Ratio (RR) = 2.2; p<0.001). Among these patients, those with more than 3 fractured ribs (106/143 vs. 41/66 patients, RR=1.2; p<0.05) or flail chest (45/143 vs. 11/66 patients, RR=1.9; p<0.05) were more frequently seen in the earthquake cohort. Earthquake-related crush injuries more frequently resulted in bilateral rib fractures (66/143 vs. 18/66 patients, RR= 1.7; p<0.01). Additionally, the incidence of non-rib fracture was higher in the earthquake cohort (85 vs. 60 patients, RR= 1.4; p<0.01). Pulmonary parenchymal and pleural injuries were more frequently seen in earthquake-related crush injuries (117 vs. 80 patients, RR=1.5 for parenchymal and 146 vs. 74 patients, RR = 2.0 for pleural injuries; p<0.001). Non-rib fractures, pulmonary parenchymal and pleural injuries had significant positive correlation with rib fractures in these two cohorts.
  
  
  CONCLUSIONS
  Thoracic crush traumas resulting from the earthquake were life threatening with a high incidence of bony thoracic fractures. The ribs were frequently involved in bilateral and severe types of fractures, which were accompanied by non-rib fractures, pulmonary parenchymal and pleural injuries.
authors.affiliation: Department of Radiology, West China Hospital, Sichuan University, Chengdu, China. dongzhih@163.com
authors.forename: Zhi-Hui
authors.initials: ZH
authors.lastname: Dong
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Yang
authors.forename: Tian-Wu
authors.initials: TW
authors.lastname: Chen
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Chu
authors.forename: Wen
authors.initials: W
authors.lastname: Deng
authors.forename: Heng
authors.initials: H
authors.lastname: Shao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D055866:Earthquakes; D005260:Female; D006801:Humans; D007223:Infant; D055370:Lung Injury / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D010994:Pleura / Q000293:injuries*; D012189:Retrospective Studies; D012253:Rib Fractures / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult