Prediction of outcomes of chest trauma using chest trauma scoring system at a rural tertiary health-care facility

Abstract

Background: In India, trauma is the most common cause of death. The third most common cause of traumatic death is thoracic trauma. Thoracic trauma accounts for 10% of all trauma admissions, and the mortality rate is reported to range from 10% to 60%. Thoracic trauma patients are likely to be assessed and cared for consistently under a well-designed classification system. Aims: This study aims To investigate Chest Trauma Score (CTS)-based prognostic and predictive outcomes following chest trauma in the Indian subpopulation sustaining chest injuries. Setting and Design: This prospective observational study, Department of General Surgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, was included a total of 50 individuals with thoracic trauma. Materials and Methods: When a patient is admitted to the emergency department or trauma unit, a complete clinical assessment, detailed history, vital signs, and all appropriate investigations - including chest radiographs, computed tomography, or high-resolution computed tomography (HRCT) chest (if hemodynamics are stable on admission) - are performed. Age, pulmonary contusion (on HRCT chest), number of rib fractures, and presence of bilateral rib fracture were the four factors used to calculate the CTS. Statistical Analysis: Data were expressed as mean (standard deviation) and percentage (%). Chi-square, Student’s t-test, and analysis of variance were used to compare measured variables. Results: The mean pulse rate (beats/min) and respiratory rate (/min) of patients were significantly higher, and systolic blood pressure (mmHg) and diastolic blood pressure (mmHg) were significantly lower in the nonsurvivor group compared with the survivor group. More than 5 rib fractures and intubation were significantly found more in nonsurvivor group. The mean Glasgow Coma Scale (GCS) was significantly decreased in nonsurvivor group (11.67 ± 1.37) as compared to survivor group (14.55 ± 1.13). Conclusion: Traffic accidents were more frequently (60%) responsible for chest trauma. The mean GCS was significantly associated with patient mortality.