Skip to main content

Advertisement

Log in

Age and traumatic chest injury: a 3-year observational study

  • Original Article
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

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).

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Lema MK, Chalya PL, Mabula JB, Mahalu W. Pattern and outcome of chest injuries at Bugando Medical Centre in Northwestern Tanzania. J Cardiothorac Surg. 2011;6:7.

    Article  PubMed  Google Scholar 

  2. Wisner DH. Trauma to chest. In: Sabiston DC, Spencer FE, editors. Surgery of the chest. 6th ed. Philadelphia: Saunders; 1995.

    Google Scholar 

  3. Miller DL, Mansour KA. Blunt traumatic lung injuries. Thorac Surg Clin. 2007;17:57–61.

    Article  PubMed  Google Scholar 

  4. Ali N, Gali BM. Pattern and management of chest injuries in Maiduguri, Nigeria. Ann Afr Med. 2004;3:181–4.

    Google Scholar 

  5. Adem AA, Ilagoa R, Mekonen E. Chest injuries in Tikur Anbessa Hospital, Addis Ababa, Ethiopia: 3-year experience. East Cent Afr J Surg. 2009;6:11–4.

    Google Scholar 

  6. Archampong EQ, Anyawu CH, Ohaegbulum SC. Management of the injured patient. In: Badoe EA, Archampong EQ, Jaja MO, editors. Principles and practice of surgery, including pathology in the tropics. Tema: Ghana Publishing Company; 1994. p. 139–43.

    Google Scholar 

  7. Frimpong-Boateng K, Amoati ABG. Chest injuries in Ghana. West Afr J Med. 2000;19:175.

    Google Scholar 

  8. World Health Organization (WHO). Global status report on road safety: time for action. 2009. http://whqlibdoc.who.int/publications/2009/9789241563840_eng.pdf. Accessed 26 June 2012.

  9. Burgut HR, Bener A, Sidahmed H, Albuz R, Sanya R, Khan WA. Risk factors contributing to road traffic crashes in a fast-developing country: the neglected health problem. Ulus Travma Acil Cerrahi Derg. 2010;16(6):497–502.

    PubMed  Google Scholar 

  10. Mamtani R, Al-Thani MH, Al-Thani AA, Sheikh JI, Lowenfels AB. Motor vehicle injuries in Qatar: time trends in a rapidly developing Middle Eastern nation. Inj Prev. 2012;18(2):130–2.

    Article  PubMed  Google Scholar 

  11. Catoire P, Orliaguet G, Liu N, et al. Systematic transesophageal echocardiography for detection of mediastinal lesions in patients with multiple injuries. J Trauma. 1995;38:96–102.

    Article  PubMed  CAS  Google Scholar 

  12. Grimes OF. Nonpenetrating injuries to the chest wall and esophagus. Surg Clin North Am. 1972;53:597–609.

    Google Scholar 

  13. Bishop M, Shoemaker WC, Avakian S, et al. Evaluation of a comprehensive algorithm for blunt and penetrating thoracic and abdominal trauma. Am J Surg. 1991;57:737–46.

    CAS  Google Scholar 

  14. Bener A, Omar AO, Ahmad AE, Al-Mulla FH, Abdul Rahman YS. The pattern of traumatic brain injuries: a country undergoing rapid development. Brain Inj. 2010;24(2):74–80.

    Article  PubMed  Google Scholar 

  15. Greenfield B. The world’s richest countries. Forbes. 2012. http://www.forbes.com/sites/bethgreenfield/2012/02/22/the-worlds-richest-countries/. Accessed 26 June 2012.

  16. Association for the Advancement of Automotive Medicine. 2011. http://www.aaam.org/. Accessed 26 June 2012.

  17. Galan G, Peñalver JC, París F, et al. Blunt chest injuries in 1696 patients. Eur J Cardiothorac Surg. 1992;6:284–7.

    Article  PubMed  CAS  Google Scholar 

  18. Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S. Chest injury due to blunt trauma. Eur J Cardiothorac Surg. 2003;23:374–8.

    Article  PubMed  Google Scholar 

  19. William F, Anita L, Charlene M. Injury to the chest, complications and management: experience at a Level I trauma centre. Am J Surg. 1996;1–6.

  20. Al-Dulimi HH, Abosalah S, Abdulaziz A, Bener AB. Trauma mortality in the state of Qatar, 2006–2007. J Emerg Med Trauma Acute Care. 2010;9:19–25.

    Google Scholar 

  21. Hanafi M, Al-Sarraf N, Sharaf H, Abdelaziz A. Pattern and presentation of blunt chest trauma among different age groups. Asian Cardiovasc Thorac Ann. 2011;19:48–51.

    Article  PubMed  Google Scholar 

  22. Segers P, Van Schil P, Jorens P, Van Den Brande F. Thoracic trauma: an analysis of 187 patients. Acta Chir Belg. 2001;101(6):277–82.

    PubMed  CAS  Google Scholar 

  23. Cooper C, Militello P. The multiple injured patient: Maryland shock trauma protocol approach. Semin Thorac Cardiovasc Surg. 1992;4:163–7.

    PubMed  CAS  Google Scholar 

  24. Athanassiadi K, Gerazounis M, Theakos N. Management of 150 flail chest injuries: analysis of risk factors affecting outcome. Eur J Cardiothorac Surg. 2004;26:373–6.

    Article  PubMed  Google Scholar 

  25. Bener A, Hussain SJ, Ghaffar A, Abou-Taleb H, El-Sayed HF. Trends in childhood trauma mortality in the fast economically developing state of Qatar. World J Pediatr. 2011;7(1):41–4.

    Article  PubMed  Google Scholar 

  26. El-Faramawy A, El-Menyar A, Zarour A, et al. Presentation and outcome of traumatic spinal fractures. J Emerg Shock Trauma. 2012;5:316–20.

    Article  Google Scholar 

  27. Bener A, Crundall D. Role of gender and driver behaviour in road traffic crashes. Int J Crashworthiness. 2008;13:331–6.

    Article  Google Scholar 

  28. Holcomb JB, McMullin NR, Kozar RA, Lygas MH, Moore FA. Morbidity from rib fractures increases after age 45. J Am Coll Surg. 2003;196(4):549–55.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank the staff of the Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.

Conflict of interest

The authors have no conflict of interest and no financial issues to disclose.

Ethical standard

This study was conducted with the approval of the Medical Research Center at Hamad Medical Corporation, Qatar, IRB #12010/12.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. El-Menyar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

El-Menyar, A., Latifi, R., AbdulRahman, H. et al. Age and traumatic chest injury: a 3-year observational study. Eur J Trauma Emerg Surg 39, 397–403 (2013). https://doi.org/10.1007/s00068-013-0281-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-013-0281-7

Keywords

Navigation