Survival Rate of Patients with Cardiothoracic Injuries in Road Traffic Accidents, and their Relationship with ISS, GCS and blood transfusions.
DOI:
https://doi.org/10.26641/2307-0404.2018.3.147958Keywords:
cardiothoracic injuries, ISS, GCS, blood transfusionsAbstract
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.
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
Issue
Section
License
Copyright (c) 2018 Medicni perspektivi (Medical perspectives)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submitting manuscript to the journal "Medicni perspektivi" the author(s) agree with transferring copyright from the author(s) to publisher (including photos, figures, tables, etc.) editor, reproducing materials of the manuscript in the journal, Internet, translation into other languages, export and import of the issue with the author’s article, spreading without limitation of their period of validity both on the territory of Ukraine and other countries. This and other mutual duties of the author and all co-authors separately and editorial board are secured by written agreement by special form to use the article, the sample of which is presented on the site.
Author signs a written agreement and sends it to Editorial Board simultaneously with submission of the manuscript.