title: Age and traumatic chest injury: a 3-year observational study.
abstract: BACKGROUND
  A quarter of trauma-related deaths are attributable to traumatic chest injury (TCI).
  
  
  OBJECTIVE
  To outline the pattern and outcome of TCI in a rapidly developing country among different age groups.
  
  
  METHODS
  We conducted a retrospective observational study for patients who sustained TCI and admitted between January 2008 and December 2010 to the Level I trauma center at Hamad General Hospital in Qatar. Patients were classified and analyzed in four age groups (group 1 ≤18, group 2 between 19-44, group 3 45-59, and group 4 >60 years). Multivariate regression analysis was performed for predictors of mortality.
  
  
  RESULTS
  Of 5,118 cases admitted to the Section of Trauma Surgery, 1,355 (26.5 %) had TCI (12, 67, 16, and 5 % in groups 1-4, respectively), which was due to blunt trauma in 96 % of cases. The overall mean age was 33 ± 15 years and males comprised 94 % of cases. Children (≤18 years of age) had more traffic-related injury, intubation, high Injury Severity Score (ISS) (19 ± 12), and associated head and liver injuries in comparison to the other groups. The overall mortality rate was 13 % (24, 11, 12, and 16 % in groups 1-4, respectively). The death rate was higher in pedestrians, followed by motor vehicle crashes (MVCs) and fall-related injuries (24 vs. 13 vs. 7 %, respectively, p = 0.001). The highest mortality occurred within the first day (n = 115, 65 %). In comparison to old age, children were more likely to die early (on the first day) and the adult group died mostly within the first week of hospitalization. Independent predictors for mortality included associated head injury [odds ratio (OR) 2.3, 95 % confidence interval (CI) 1.48-3.62), ISS (OR 1.11, 95 % CI 1.09-1.13), and age (OR 0.37, 95 % CI 0.22-0.62).
  
  
  CONCLUSIONS
  TCI is an alarming problem in Qatar, with a bimodal mortality curve. The highest mortality peak occurred in children, followed by old age. However, young males are the most exposed population. Regulatory efforts and strict enforcement of traffic laws would likely reduce morbidity and mortality.
authors.affiliation: Clinical Research, Section of Trauma Surgery, Hamad General Hospital, P.O. Box 3050, Doha, Qatar. aymanco65@yahoo.com.|Clinical Medicine, Weill Cornell Medical School, Doha, Qatar. aymanco65@yahoo.com.
authors.forename: A
authors.initials: A
authors.lastname: El-Menyar
authors.affiliation: Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.|Department of Surgery, Arizona University, AZ, USA.
authors.forename: R
authors.initials: R
authors.lastname: Latifi
authors.affiliation: Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: H
authors.initials: H
authors.lastname: AbdulRahman
authors.affiliation: Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: A
authors.initials: A
authors.lastname: Zarour
authors.affiliation: Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: M
authors.initials: M
authors.lastname: Tuma
authors.affiliation: Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: A
authors.initials: A
authors.lastname: Parchani
authors.affiliation: Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: R
authors.initials: R
authors.lastname: Peralta
authors.affiliation: Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: H
authors.initials: H
authors.lastname: Al Thani
keywords: Age; Chest injury; Mortality; Qatar; Trauma
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