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Demographic, Clinical Features and Outcome Determinants of Thoracic Trauma in Sri Lanka: A Multicentre Prospective Cohort Study
Joint Authors
Mathangasinghe, Y.
Pradeep, Iddagoda Hewage Don Saman
Rasnayake, Dhammike
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-06-20
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Prognostic determinants in thoracic trauma are of major public health interest.
We intended to describe patterns of thoracic trauma, demographic factors, clinical course, and predictors of outcome in selected tertiary care hospitals in Sri Lanka.
A multicentre prospective cohort study was conducted in five leading teaching hospitals from June to September 2017.
Patients with thoracic trauma were followed up during the hospital stay.
A logistic regression analysis was conducted using in-hospital morbidity as the dichotomous outcome variable.
One hundred seventy-one patients were included in the study yielding 1450 (median = 8.5) person-days of observation.
Of them, 71.9% (n = 123) were males.
The mean age was 45.8 ± 17.9 years.
Majority (39.2%, n = 67) were recruited from the National Hospital of Sri Lanka.
Automobile accidents were the commonest (62.6%, n = 107), followed by falls (26.9%, n = 46), assaults (8.8%, n = 15), and animal attacks (1.8%, n = 3).
The ratio of blunt to penetrating trauma was 5.6 : 1.
Injury patterns were rib fractures (80.7%, n = 138), haemothorax (44.4%, n = 76), pneumothorax (44.4%, n = 76), lung contusion (22.8%, n = 39), flail segment (15.8%, n = 27), tracheobronchial trauma (7.0%, n = 12), diaphragmatic injury (2.3%, n = 4), vascular injury (2.3%, n = 4), cardiac contusions (1.1%, n = 2), and oesophageal injury (0.6%, n = 1).
Ninety nine (57.9%) had extrathoracic injuries.
Majority (63.2%, n = 108) underwent operative management including intercostal tube insertion (60.8%, n = 104), wound exploration (6.4%, n = 11), thoracotomy (4.1%, n = 7), rib reconstruction (4.1%, n = 7), and video-assisted thoracoscopic surgery (2.9%, n = 5).
Pneumonia (10.5%, n = 8), bronchopleural fistulae (2.3%, n = 4), tracheaoesophageal fistulae (1.8%, n = 3), empyema (1.2%, n = 2), and myocardial infarction (1.2%, n = 2) were the commonest postoperative complications.
The mean hospital stay was 15.6 ± 18.0 days.
The in-hospital mortality was 11 (6.4%).
The binary logistic regression analysis with five predictors (age, gender, mechanism of injury (automobile/fall/assault), type of trauma (blunt/penetrating), and the presence of extrathoracic injuries) was statistically significant to predict in-hospital morbidity (X2 (6, n = 168) = 13.1; p=0.041), explaining between 7.5% (Cox and Snell R2) and 14.5% (Nagelkerke R2) of variance.
The automobile accidents (OR: 2.3, 95% CI = 0.2–26.2) and being males (OR: 2.3, 95% CI = 0.6–9.0) were the strongest predictors of morbidity.
American Psychological Association (APA)
Mathangasinghe, Y.& Pradeep, Iddagoda Hewage Don Saman& Rasnayake, Dhammike. 2020. Demographic, Clinical Features and Outcome Determinants of Thoracic Trauma in Sri Lanka: A Multicentre Prospective Cohort Study. Canadian Respiratory Journal،Vol. 2020, no. 2020, pp.1-6.
https://search.emarefa.net/detail/BIM-1152069
Modern Language Association (MLA)
Mathangasinghe, Y.…[et al.]. Demographic, Clinical Features and Outcome Determinants of Thoracic Trauma in Sri Lanka: A Multicentre Prospective Cohort Study. Canadian Respiratory Journal No. 2020 (2020), pp.1-6.
https://search.emarefa.net/detail/BIM-1152069
American Medical Association (AMA)
Mathangasinghe, Y.& Pradeep, Iddagoda Hewage Don Saman& Rasnayake, Dhammike. Demographic, Clinical Features and Outcome Determinants of Thoracic Trauma in Sri Lanka: A Multicentre Prospective Cohort Study. Canadian Respiratory Journal. 2020. Vol. 2020, no. 2020, pp.1-6.
https://search.emarefa.net/detail/BIM-1152069
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1152069