Survival Rate of Patients with Cardiothoracic Injuries in Road Traffic Accidents, and their Relationship with ISS, GCS and blood transfusions.

Authors

  • Khalid Fahad Almalki
  • Abdullah Mussad Alharbi
  • Anthony Morgan
  • Adel Mohammed Bin Sultan
  • Saud Ayedh Alajmi
  • Turke Ali Alajmi
  • Arif Mohammed Alanazi
  • Mohammed Ibrahim Alsheddi
  • Ali Abdulaziz Alanzan
  • Zayed Fahd Al-Dosari

DOI:

https://doi.org/10.26641/2307-0404.2018.3.147958

Keywords:

cardiothoracic injuries, ISS, GCS, blood transfusions

Abstract

Severe thoracic trauma is one of the major causes of injury-related mortality. In the United States, thoracic trauma results in one-fourth of all trauma deaths. Globally, cardiothoracic trauma is also a major contributor to mortality. The most common cardiothoracic injuries include rib fractures, thoracic vertebral fractures, haemothorax, pneumothorax, flail chest, and lung contusions. The purpose of the present study was to determine the survival rate of patients with cardiovascular injuries in road traffic accidents and its relationship with ISS, GCS and blood transfusions at King Khalid Hospital. This study is a useful addition to the literature, as research in this topic is lacking. A total of 189 patients were transported to the hospital with cardiothoracic injuries during the study period. Data was gathered regarding age, gender, nationality, vehicle user type, anatomical region injured, Intensive Care Unit (ICU) admission, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), blood transfusion, treatment and mortality rate. The neurological status was assessed using the GCS score. Injury Severity Scores were calculated to categorize the injury severity. The mean patient age was 31.81 years, with a peak age of between 21–30 years. Males predominated (93.7%) with a male to female ratio of 15:1. Most of the patients were Saudi nationals (61.3%). Overall mortality was 7.9%. Factors that were significantly associated with mortality were head and neck involvement, ICU admission, age (above 60), treatment delivered, and blood transfusions. Cardiothoracic trauma is associated with a high mortality rate, which may depend on the clinical presentation such as GCS, ISS, degree of shock, pattern of injuries, and associated injuries. Immediate management is vital for patients with life-threatening cardiothoracic trauma, as mortality is high if the diagnosis is missed, wrong or left untreated.

Author Biographies

Khalid Fahad Almalki

Prince Sattam Bin Abdulaziz University, Colleges of Medicine 
Al-kharj, KSA

Abdullah Mussad Alharbi

King Saud Medical City 
Riyadh, KSA

Anthony Morgan

Prince Sattam Bin Abdulaziz University, Colleges of Medicine 
Department of Surgery
Al-kharj, KSA

Adel Mohammed Bin Sultan

General Organization for Military Industries hospital in Al Kharj 
Alkharj , KSA

Saud Ayedh Alajmi

Prince Sattam Bin Abdulaziz University, Colleges of Medicine 
Al-kharj, KSA

Turke Ali Alajmi

Prince Sattam Bin Abdulaziz University, Colleges of Medicine 
Al-kharj, KSA

Arif Mohammed Alanazi

Prince Sattam Bin Abdulaziz University, Colleges of Medicine 
Al-kharj, KSA

Mohammed Ibrahim Alsheddi

Prince Sattam Bin Abdulaziz University, Colleges of Medicine 
Al-kharj, KSA

Ali Abdulaziz Alanzan

Prince Sattam Bin Abdulaziz University, Colleges of Medicine 
Al-kharj, KSA

Zayed Fahd Al-Dosari

Prince Sattam Bin Abdulaziz University, Colleges of Medicine 
Al-kharj, KSA

References

Demirhan R, Onan B, Oz K, Halezeroglu S. Com­prehensive analysis of 4205 patients with chest trauma: a 10-year experience. Interactive CardioVascular and Thoracic Surgery. 2009;9(3):450-3.

Shorr RM, Crittenden M, Indeck M, Hartunian SL, Rodriguez A. Blunt thoracic trauma. Analysis of 515 patients.Annals of Surgery. 1987;206(2):200-5.

Milos A. Thoracic trauma; 2012. Available from: https://www.researchgate.net/publication/301685544_Thoracic_Trauma

Kumar AG, Honnungar RS, Kumar TS, Hallikeri VR. Pattern of chest injuries in road traffic incident victims: a six-year retrospective study.Medicine, Science, and the Law. 2011;51(2):93-96.

El-Menyar A, Latifi R, AbdulRahman H, Za­rour A, Tuma M, Parchani A, et al. Age and traumatic chest injury: a 3-year observational study. European Journal of Trauma and Emergeny Surgery. 2013;39(4):397-403.

Elnibras M, Abdullah AAA,AlbalawiIA, Elsid­dig SM. Pattern and mortality of chest injuries among victims of road traffic accidents in a tertiary hospWest Saudi Arabia. Merit Research Journal of Medicine and Medical Sciences. 2017;5(10):484-94.

Aggarwal R, Soni KD, Gupta A, Kumar S. Out­come of patients of chest trauma suffering from chronic obstructive pulmonary disease - experience at level 1 trauma centre. Anaesthesiology Intensive Therapy. 2016;48(3):162-5.

Yu W, Chen H, Lv Y, Deng Q, Kang P, Zhang L. Comparison of influencing factors on outcomes of single and multiple road traffic injuries: A regional study in Shan­ghai, China (2011-2014). PLoS One. 2017;12(5):e0176907.

Baker SP, O’Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. ournal of Trauma and Acute Care Surgery. 1974;14(3):187-96.

Aharonson-Daniel L, Giveon A, Stein M. Israel Trauma Group, Peleg K. Different AIS triplets: different mortality predictions in identical ISS and NISS. The Journal of Trauma. 2006;61(3):711-7.

Moon SH, Kim JW, Byun JH, Kim SH, Choi JY, Jang IS, et al. The thorax trauma severity score and the trauma and injury severity score: Do they predict in-hospital mortality in patients with severe thoracic trauma? A retrospective cohort study. Medicine (Baltimore). 2017;96(42):e8317.

Abdulaziz AA, Radhi GA, Morgan A, Alhar­bi AS, Aljuraid FF, Aldawsari AM, et al. Injuries type and its relation with Glasgow Coma Scale, injury severity score and blood transfusion in road traffic accident victims. Medicni perspektivi; 2018;23(2):148-59. https://doi.org/10.26641/2307-0404.2018.2.133954

Martinez Casas I, Amador Marchante MA, Padu­raru M, Fabregues Olea AI3, Nolasco A, Medina JC. Thorax trauma severity score: is it reliable for patient's evaluation in a secondary level hospital? Bulletin of Emergency and Trauma. 2016;4(3):150-5.

AlEassa EM, Al-Marashda MJ, Elsherif A, Eid HO, Abu-Zidan FM. Factors affecting mortality of hospi­talized chest trauma patients inUnited Arab Emirates. Journal of cardiothoracic Surgery. 2013;8:57.

Wang SH, Wei TS, Chen CP. Prognostic analysis of patients with blunt chest trauma admitted to an in­tensive care unit.Journal of the Formosan Medical As­sociation. 2007;106(6):444-51.

Lien YC, Chen CH, Lin HC. Risk factors for 24-hour mortality after traumatic rib fractures owing to motor vehicle accidents: a nationwide population-based study. The Annals of thoracic Surgery. 2009;88(4):1124-30.

Alam El-Din ML, Nashy MR, Meshhal M. Blunt vs. penetrating chest trauma in terms of the outcome in Menoufia University Hospital. Menoufia Medical journal. 2018;31(1):133-9.

Ekpe EE. Eyo C. Determinants of mortality in chest trauma patients. Nigerian Journal of Surgery. 2014;20(1):30-34.

El-Menyar A, Abdelrahman H, Al-Hassani A, et al. Clinical presentation and time-based mortality in patients with chest injuries associated with road traffic accidents. Archives of Trauma Research. 2016;5(1):e31888.

Manay P, Satoskar RR, Karthik V, Prajapati RP. Studying morbidity and predicting mortality in patients with blunt chest trauma using a novel clinical score. Journal of Trauma, Emergencies and Shock. 2017;10(3):128-33.

VeysiVT, Nikolaou VS, Paliobeis C, et al. Pre­valence of chest trauma, associated injuries and mortality: a level I trauma centre experience. International Ortho­paedics. 2009;33(5):1425-33.

Okugbo SU, Okoro E,IrhibogbePE. Chest trau­ma in a regional trauma centre. Journal of theWestAfricanCollegeof Surgeons. 2012;2(2):74-84.

Downloads

How to Cite

1.
Almalki KF, Alharbi AM, Morgan A, Bin Sultan AM, Alajmi SA, Alajmi TA, Alanazi AM, Alsheddi MI, Alanzan AA, Al-Dosari ZF. Survival Rate of Patients with Cardiothoracic Injuries in Road Traffic Accidents, and their Relationship with ISS, GCS and blood transfusions. Med. perspekt. [Internet]. 2018Nov.29 [cited 2024Apr.19];23(3):59-67. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/147958

Issue

Section

CLINICAL MEDICINE