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A study to evaluate the clinico-etiologic profile and management of patients with trauma to the chest in a tertiary care Hospital

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A study to evaluate the clinico-etiologic profile and management of patients with trauma to the chest in a tertiary care Hospital

Abstract

Aim: The aim of the study to evaluate the trauma to the chest. Methods: This was a prospective observational study conducted in the Department of General Surgery, Anugrah Narayan Magadh Medical College & Hospital, Gaya, Bihar, India for 10 months. 100 cases were included in this study. Radiological, blood investigations done and subsequent management done according to clinical and radiological findings. Additional workup like blood grouping and cross matching, arterial blood gas, ultrasonography of chest and abdomen, computed tomography or other radiological investigation as and when required were done and recorded. Both blunt and penetrating chest trauma were taken into consideration. Results: The incidence of chest trauma in this study was 21.19%.The mean average age was 36.25 years. The male to female ratio in this study was M:F=3.54:1.The commonest mode of injury was RTA comprising of 63%. Next common cause was assault followed by accidental fall accounting for 15 cases (15%) and 13 cases (13%) respectively. Accidental injuries were the major group comprising of 91% whereas rest were homicidal cases 9%. Blunt force was the most common mechanism of injury comprisingof 93% of cases whereas penetrating force contributed to 7% of cases. Rib fracture was the commonest skeletal injury in 25% cases. Clavicle fracture was the next common in 13% patients. In this study most of the patients (82%) were treated by the conservative line of management. Management with tube thoracostomy was required in 15% for the patients with significant haemothorax, pneumothorax, hemopneumothorax, tension pneumothorax. Of these 15 cases 1 patients required mechanical ventilation. Pain management is an important aspect in management of chest trauma. The severity of pain in our study patientswas evaluated with the help of visual analogue scale (VAS). Conclusion: Chest trauma commonly affects young males with RTA causing significant morbidity and mortality. Majority of patients can be treated conservatively.

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