title: Analysis of epidemiology, lesions, treatment and outcome of 354 consecutive cases of blunt and penetrating trauma to the chest in an African setting.
abstract: BACKGROUND
  The proportion of death and disability related to trauma is increasing in Third-World countries. Thoracic trauma is significantly involved, but few data are available on this issue in African countries with specific local conditions.
  
  
  METHODS
  The aim of the study is to analyse the diagnosis and management procedures in thoracic trauma in a typical African country. The records of 354 patients admitted to an emergency unit for chest trauma over a 13-year period were retrospectively analysed.
  
  
  RESULTS
  The sample included patients with 231 cases of blunt and 123 of penetrating trauma to the chest; their mean age was 41.86 years, and the male:female ratio was 4.2:1. The majority (N=226) of the injuries were sustained in road traffic accidents, and the most common lesions were rib fractures (50.3%) and haemothorax (38.7%). The diagnosis was based on physical examination and standard chest radiographs in most cases. At least one associated lesion was found in 260 (73.45%) patients. The mean injury severity score (ISS) for our patients was 16.39. Most patients were managed conservatively (N=303); thoracotomy was performed mostly on penetrating trauma patients. Morbidity occurred in 49 patients, mainly affecting those treated with thoracic drainage, and 27 patients (7.6%) died. Factors related to mortality were ISS score and association with neurotrauma.
  
  
  CONCLUSIONS
  Chest trauma can be managed in our Cameroonian environment, with morbidity and mortality comparable with that of Western countries. Diagnosis must still rely on physical examination, chest radiographs and thoracic echography, which are affordable tools.
authors.affiliation: University of Buéa, Cameroon. alainchichom@yahoo.com
authors.forename: Alain Chichom
authors.initials: AC
authors.lastname: Mefire
authors.forename: Jean Jaques
authors.initials: JJ
authors.lastname: Pagbe
authors.forename: Marcus
authors.initials: M
authors.lastname: Fokou
authors.forename: Jean Francois
authors.initials: JF
authors.lastname: Nguimbous
authors.forename: Marc Leroy
authors.initials: ML
authors.lastname: Guifo
authors.forename: Jean
authors.initials: J
authors.lastname: Bahebeck
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D002163:Cameroon / Q000453:epidemiology; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012253:Rib Fractures / Q000453:epidemiology / Q000628:therapy; D013898:Thoracic Injuries / Q000453:epidemiology*; D013907:Thoracostomy / Q000706:statistics & numerical data; D014949:Wounds, Nonpenetrating / Q000453:epidemiology; D014950:Wounds, Penetrating / Q000453:epidemiology; D055815:Young Adult