Chest injury due to blunt trauma

TLDR

Blunt chest trauma carries high morbidity and mortality, necessitating recognition of high‑risk patients. The study aimed to identify the pathologies of blunt chest injuries and determine factors that accurately predict patients at high risk for major chest trauma, including the relationship between rib fracture count and associated injuries. A retrospective review of 1,490 blunt chest trauma patients over two years divided them into groups by rib fracture number and analyzed age, Injury Severity Score, and mortality, with an average stay of 4.5 days. Mortality rose with rib fracture count (1% overall, 4.7% with >2 fractures, 17% with flail chest) and was significantly associated with age, ISS ≥ 16, and the presence of more than two fractures, while pneumothorax/hemothorax occurred in 6.7% (no fractures), 24.9% (1–2 fractures), and 81.4% (>2 fractures).

Abstract

Given its importance in trauma practice, we aimed to determine the pathologies associated with blunt chest injuries and to analyze the accurate identification of patients at high risk for major chest trauma.We reviewed our experience with 1490 patients with blunt chest injuries who were admitted over a 2-year period. Patients were divided into three groups based on the presence of rib fractures. The groups were evaluated to demonstrate the relationship between the number of rib fractures and associated injuries. The possible effects of age and Injury Severity Score (ISS) on mortality were analyzed.Mean hospitalization time was 4.5 days. Mortality rate was 1% for the patients with blunt chest trauma, 4.7% in patients with more than two rib fractures and 17% for those with flail chest. There was significant association between the mortality rate and number of rib fractures, the patient's age and ISS. The rate of development of pneumothorax and/or hemothorax was 6.7% in patients with no rib fracture, 24.9% in patients with one or two rib fractures and 81.4% in patients with more than two rib fractures. The number of rib fractures was significantly related with the presence of hemothorax or pneumothorax.Achieving better results in the treatment of patients with chest wall injury depend on a variety of factors. The risk of mortality was associated with the presence of more than two rib fractures, with patients over the age of 60 years and with an ISS greater than or equal to 16 in chest trauma. Those patients at high risk for morbidity and mortality and the suitable approach methods for them should be acknowledged.