title: [Prevalence and mortality of severe chest trauma in Three Gorges Area of China].
abstract: OBJECTIVE
  To analyze the epidemiological features of severe chest trauma (SCT) and investigate the risk factor of its mortality in the Three Gorges Area of China.
  
  
  METHODS
  The clinical data of 1834 SCT patients who were admitted in three hospitals in this area from January 1990 to December 2009 were retrospectively reviewed. Th epidemiological features of SCT were analyzed using a database. Stepwise logistic regression analysis was used to analyze 15 possible risk factors affecting mortality.
  
  
  RESULTS
  The morbidity rates of blunt trauma (68.5% vs. 74.7%,p=0.006) and sharp instrument injury (12.2% vs. 15.9%,p=0.039) showed significant differences before and after 2000. The pre-hospital time [(3.45±2.38)h vs. (2.20±4.39)h,p<0.01] and transfer rate (32.39% vs. 36.80%,p=0.01) significantly improved. The thoracic Abbreviated Injury Scale (AIS)(3.56±0.71vs. 3.43±0.58,p<0.01)score and Revised Trauma Score (RTS)(7.14±2.18 vs. 6.93±1.07,p<0.01) significantly increased. Treatment for pulmonary infection (12.63±4.79 vs. 17.16±6.41,p=0.019) and hemorrhagic shock (2.4±0.75 vs. 3.4±1.34,p=0.008 )was significantly improved. The leading cause of death was hypovolemic shock (59.41%). The independent rik factors of death among these SCT patients included: hemorrhagic shock (B=1.710,OR=1.291,p=0.001), multiple organ dysfunction syndrome (B=3.453,OR=1.028,p<0.001), pulmonary infection(B=2.396,OR=10.941,p<0.001), abdominal organ injury(B=1.542,OR=1.210,p=0.005), and thorax AIS(B=0.487,OR=1.622,p<0.001).
  
  
  CONCLUSIONS
  The prevalence of SCT shows an increasing trend in the Three Gorges Area in recent years, but with a decreased rate of complications and improved treatment. Age, complications, thorax AIS, and GCS are useful prognostic indicators.
authors.affiliation: Department of Cardiothoracic Surgery, China Three Gorges University,Yichang, Hubei, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Liu
authors.forename: Ding-yuan
authors.initials: DY
authors.lastname: Du
authors.forename: Xu
authors.initials: X
authors.lastname: Hu
authors.forename: Dao-kui
authors.initials: DK
authors.lastname: Xia
authors.forename: Xiao-yong
authors.initials: XY
authors.lastname: Xiang
authors.forename: Chun
authors.initials: C
authors.lastname: Huang
authors.forename: Ji-hong
authors.initials: JH
authors.lastname: Zhou
authors.forename: Jian-xin
authors.initials: JX
authors.lastname: Jiang
mesh_terms: D002681:China / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000453:epidemiology* / Q000401:mortality