Dataset Information

Bilateral thoracic trauma; presentation and management, a case series.

ABSTRACT:

Introduction

Unilateral chest trauma has been perfectly described in the literature while bilateral chest trauma has never been specifically probed, the aim of this study is to highlight the specificities, presentations, the difference in the therapeutic algorithm and outcome of patients with bilateral thoracic trauma.

Patients and methods

A single center, prospective study was carried out in four years. The data were taken directly from the patients, patient's relatives and the medical records. All patients presenting with bilateral chest trauma, admitted to the hospital overnight, were included in this study. The patients were managed according to the Advanced Trauma Life Support (ATLS) protocol which consists of primary and secondary surveys. For those patients who diagnosed to have either haemo or pneumothorax or both, thoracostomy tube was inserted. Descriptive and analytical analyses were calculated.

Results

The study included 107 patients. Bilateral blunt trauma was found in 72 (67.3%) cases while bilateral penetrating trauma was found in 35 (32.7%) patients. The most common mechanism of trauma was road traffic accidents (RTA) accounting for 68 (63.6%) victims. Overall 30-day mortality was 14.9%. In blunt trauma, 3 or more rib fracture, pulmonary contusion, intubation, and intensive care unit admission were among the predictors of increased risk of mortality.

Conclusion

Bilateral thoracic trauma has comparable patterns of presentation, choices of investigation, strategies of management, predictors of the outcome, morbidity and mortality with unilateral chest trauma.

SUBMITTER: Baram A

PROVIDER: S-EPMC6545343 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Bilateral thoracic trauma; presentation and management, a case series.

Baram Aram A Kakamad Fahmi H FH

Annals of medicine and surgery (2012) 20190525

<h4>Introduction</h4>Unilateral chest trauma has been perfectly described in the literature while bilateral chest trauma has never been specifically probed, the aim of this study is to highlight the specificities, presentations, the difference in the therapeutic algorithm and outcome of patients with bilateral thoracic trauma.<h4>Patients and methods</h4>A single center, prospective study was carried out in four years. The data were taken directly from the patients, patient's relatives and the m ...[more]

PMID: 31193971

Similar Datasets

Project description:IntroductionFalls cause 75% of trauma in patients above 65 years of age, and thoracic trauma is the second commonest injury; rib fractures are the most common thoracic injury. These patients have up to 12% mortality, with 31% developing pneumonias. There is wide variation in care. Northumbria Healthcare has a team of respiratory consultants, physiotherapists, specialist nurses and anesthetists for thoracic-trauma management on a respiratory support unit.MethodsWith Caldicott approval, basic demographics and clinical outcomes of patients admitted with thoracic trauma between 20 August-21 April were analyzed. A descriptive statistical methodology was applied.ResultsA total of 119 patients were identified with a mean age of 71.1 years (range 23-97). Of the 119 patients, 53 were male, 66 females. The main mechanism of injury was falls from standing (65) and falls down stairs/bed or in the bath (18). Length of stay was 7.3 days (range 1-54). In total, 85 patients had more than one co-morbidity, 26 had a full trauma assessment and 75 had pan CTs. The mean number of rib fractures was 3.6 and 31 (26%) patients had a pneumothorax and/or haemothorax. A total of 18 chest drains were inserted (all small bore) and one needle aspiration was performed. No cardiothoracic input was required. Isolated chest trauma was present only in 45 patients. All patients had a pain team review, 22 erector spinae catheters were inserted with 2 paravertebral blocks. Overall, 82 patients did not require oxygen, 1 required CPAP and 1 HFNC. 7 needed intensive care transfer. Furthermore, 20 (17%) developed pneumonias and 16 (14%) deaths occurred within 30 days-all were in those with falls from standing. There was no correlation between number of fractured ribs, length of stay and mortality.ConclusionsHigh level care for thoracic trauma can be performed by a physician led team. Overall, 42% pneumothoraces/haemothoraces were observed. Further large scale randomised trials are warranted for definitive outcomes.

Dataset Information

Bilateral thoracic trauma; presentation and management, a case series.

Introduction

Patients and methods

Results

Conclusion

Publications

Bilateral thoracic trauma; presentation and management, a case series.

Similar Datasets

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