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The Pattern and Outcome of Chest Injuries in South West Nigeria
Abstract
Objective: The pattern and management outcome of chest injuries
presenting to our tertiary university hospital located in a semi-urban
population in the South West of Nigeria, has not been documented
previously. We therefore sought to identify factors that may contribute
to mortality.
Method: We analyzed 114 patients presenting to the Accident and
Emergency Unit with chest trauma, prospectively entered into a data
base over a two year period.
Results: Chest trauma accounted for 6% of all trauma admissions
with a male preponderance (M:F = 3.6:1). Rib fractures were the most
common injury (46.3%) while limb fractures were the most common
associated injury (35.8%). Associated head injury accounted for most
deaths (56%) in those with severe ISS. Majority of patients (51.8%)
required only analgesics, while additional closed tube thoracostomy
drainage was necessary (41.8%) in the others who suffered blunt
trauma. Thoracotomy was indicated for only 5 (4.5%) penetrating
injuries. There is a rising trend towards penetrating gunshot injuries,
with mortality increasing with age (p=0.03) and severity of associated
injuries (ISS) (p=0.003).
Conclusion: Majority of the patients required only minimal intervention
with chest drainage or analgesics, with low mortality. Increasing
age and severity of injury contributed significantly to mortality. Initiation
of care for chest trauma victims is still delayed in our centre.
presenting to our tertiary university hospital located in a semi-urban
population in the South West of Nigeria, has not been documented
previously. We therefore sought to identify factors that may contribute
to mortality.
Method: We analyzed 114 patients presenting to the Accident and
Emergency Unit with chest trauma, prospectively entered into a data
base over a two year period.
Results: Chest trauma accounted for 6% of all trauma admissions
with a male preponderance (M:F = 3.6:1). Rib fractures were the most
common injury (46.3%) while limb fractures were the most common
associated injury (35.8%). Associated head injury accounted for most
deaths (56%) in those with severe ISS. Majority of patients (51.8%)
required only analgesics, while additional closed tube thoracostomy
drainage was necessary (41.8%) in the others who suffered blunt
trauma. Thoracotomy was indicated for only 5 (4.5%) penetrating
injuries. There is a rising trend towards penetrating gunshot injuries,
with mortality increasing with age (p=0.03) and severity of associated
injuries (ISS) (p=0.003).
Conclusion: Majority of the patients required only minimal intervention
with chest drainage or analgesics, with low mortality. Increasing
age and severity of injury contributed significantly to mortality. Initiation
of care for chest trauma victims is still delayed in our centre.
