Clinical Features, Management, and Outcomes of Chest Trauma at a Tertiary-Care Centre in India: A Retrospective Observational Study

Introduction. Chest is one of the main sites of injuries in trauma being a part of the torso. Many important organs lie in rib cage. However, data on chest injuries are scarce. Methods. A retrospective study was carried out for chest trauma patients including polytrauma (n = 184) from hospital records for five years (2016–2020). Various parameters including demographic profile, mode of injury, management, and outcomes were studied. Results. Mean age of patients was 37 ± 16 years with a male to female ratio of 2.4 : 1. Road traffic injuries remained the most common cause of trauma followed by assaults. Most of the patients were managed conservatively (55.43%). Mortality was seen in only 1.63% patients. Conclusion. Young male patients are usually affected by trauma. Road traffic injuries are the commonest cause. However, most patients can be managed by conservative treatment and mortality is seen only in polytrauma patients in the present study.

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Profile of chest injuries in a tertiary care centre

International Surgery Journal ◽

10.18203/2349-2902.isj20200809 ◽

2020 ◽

Vol 7 (3) ◽

pp. 714

Author(s):

Rajesh K. Jegoda

Keyword(s):

Chest Trauma ◽

Road Traffic ◽

Tertiary Care ◽

Clinical History ◽

Blunt Injury ◽

Trauma Patients ◽

Care Centre ◽

Tertiary Care Centre ◽

Chest Injuries ◽

A Prospective Study

Background: Trauma is a major cause of mortality worldwide. This study is aimed at the patterns of chest trauma, their presentation and the outcome of management.Methods: A prospective study of trauma patients admitted to a tertiary care centre was carried out the clinical history, physical examination and outcome of management recorded in a predesigned proforma were analysed with SPSS 15 and the patients were followed up in the surgical department.Results: A total of 638 patients were admitted. 57 patents were identified with chest trauma, 43 (75%) were males and 14 (24.56%) were females. The age range was from 3-78 years and the most affected age was in the range of 20 to 39 years. Blunt injury constituted 82.4% while road traffic accident was responsible for 70.1%. The average time taken between accident and admission was 11 hours 12 minutes while the average duration of hospital stay was 11 days. The injury pattern mainly included rib fracture and hemopneumothorax. The mortality rate was 1.75%.Conclusions: Most patients arriving at the hospital survived, requiring general resuscitation or simple tube thoracostomy with few complications. Mortalities from trauma and cause of death at the site of accident are often not accounted for due to non-presentation to the hospital and lack of autopsy for those who present.

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Clinical profile and outcome of chest trauma: a four year retrospective analysis at a tertiary care centre

International Surgery Journal ◽

10.18203/2349-2902.isj20192985 ◽

2019 ◽

Vol 6 (7) ◽

pp. 2519

Author(s):

Syed Quibtiya Khursheed ◽

Waseem Ashraf ◽

Ajaz Ahmad Rather ◽

Shams-Ul-Bari .

Keyword(s):

Traffic Accidents ◽

Chest Trauma ◽

Road Traffic ◽

Tertiary Care ◽

Chest Injury ◽

Trauma Patients ◽

Road Traffic Accidents ◽

Associated Injuries ◽

Tertiary Care Centre ◽

Chest Injuries

Background: Chest trauma comprises about 10-15% of all traumas and 25% of all deaths from traumatic injury. Chest injuries are cause by blunt mechanisms such as road traffic accidents or penetrating mechanisms such as stab and missile injuries. Traumatic chest injuries are the most common cause of preventive mortality and morbidity.Methods: A retrospective study of all patients with chest injury presenting to Emergency Department of SKIMS Medical College, Srinagar was done. Records of all the patients were retrieved. A complete data regarding age, gender, mode/type of injury, extra thoracic injuries, mode of management and outcome was gathered.Results: A total number of 1429 trauma patients presented to AE of which 160 patients (11.2%) had chest trauma. Majority of the patients (51.87%, n=83) were of age group of 21-40 years. A male preponderance was observed. Road traffic accidents were major causes of blunt chest injury, while gunshot injury was the major causes of penetrating chest injuries. Head and neck injuries were the most common associated injuries. Tube thoracostomy was the commonest modality of management (65%) and (28%) patients were managed conservatively. Severity of chest trauma and associated injuries coupled with prompt diagnosis and treatment were important factors in efficient management of chest injuries.Conclusions: Chest trauma resulting from road traffic accidents remains the major mechanism of injury. Preventive measures aimed at educating the common masses about traffic rules and strictly implementing them is indispensable to reduce the incidence of chest injuries.

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Epidemiology of fractures in indoor patients at a tertiary care centre in India: a study of 3000 cases

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20214958 ◽

2021 ◽

Vol 8 (1) ◽

pp. 39

Author(s):

Mohan M. Desai ◽

Deven R. Kuruwa ◽

Easwar Elango ◽

Roshan Wade

Keyword(s):

Road Traffic ◽

Tertiary Care ◽

Age Groups ◽

Control Measures ◽

Age Group ◽

Care Centre ◽

Tertiary Care Centre ◽

Treatment Protocols ◽

Female Ratio ◽

Femur Fractures

Background: Implementing appropriate fracture control measures and treatment protocols is crucial to maximizing health and development gains. This requires an in depth understanding of age-specific, sex-specific and cause-specific injury patterns at the national and subnational levels. No such study on fracture epidemiology has been undertaken in the Indian population.Methods: Study was conducted in a tertiary care centre (KEM hospital, Mumbai) which is one of the highest volume trauma centres in the country. Data of 3000 patients was obtained from the medical records department for the year 2016-2019. Patients were segregated with respect to their genders and into three age groups. Etiology of fracture was noted, and fractures classified according to the anatomical area. Whether the patient received conservative or operative management was also recorded.Results: 43.83% of the fractures occurred in 18-50 years age group. 41.33% in the above 50 group and only 14.73% in the below 18 age group. Overall male to female ratio was 1.4: 1. Vehicular accident was the most common mode of injury (47.07%) followed by fall from height (21.03%). Proximal femur fractures were the most common accounting for 19.57% of all fractures followed by forearm (10.53%), tibia diaphysis (8.10%). Talus was the least common. 81.07% cases were managed operatively and 18.93% conserved.Conclusions: Our study highlights that Indian epidemiology is unique from our Western counterparts. Population affected is much younger, old age males are affected more than females. Lower limb fractures are more prevalent and road traffic accidents are responsible for almost half the fractures.

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Clinical study of patients with trauma to the chest in a tertiary care centre

International Surgery Journal ◽

10.18203/2349-2902.isj20202561 ◽

2020 ◽

Vol 7 (7) ◽

pp. 2135

Author(s):

Vijay D. Potey ◽

Karan D. Kale ◽

Vijay B. Kanake

Keyword(s):

Chest Trauma ◽

Road Traffic ◽

Average Length ◽

Tertiary Care ◽

Length Of Hospital Stay ◽

Normal Activity ◽

Common Mechanism ◽

Care Hospital ◽

Tertiary Care Centre ◽

Intercostal Nerve Block

Background: Chest trauma is one of the serious injuries and also one of the leading causes of death from physical trauma. Current study is designed to study clinical profile, pattern of injuries, complications and treatment modality required in chest trauma management.Methods: A prospective observational study was conducted in Shri Vasantrao Naik Government Medical College, a tertiary care hospital in Yavatmal, Maharashtra, India in 246 patients primarily admitted for chest trauma from 1st March 2018 to 31st August 2019. All cases were managed in emergency department with history noted, clinical examination performed and initial management done as per ATLS guidelines. Definitive management done according to clinical and radiological investigations. Final outcome (death/discharge) was noted with discharged patients were followed until normal activity regained.Results: Male of 3rd-4th decade constituted most vulnerable group, with mean age of 38.56 years and male:female ratio of 5.31:1. Road traffic accident (RTA) was the commonest cause (71.14%), followed by assault (11.79%) and accidental fall (11.38%). Blunt force was the most common mechanism (93.09%). Rib fracture was present in 26.83%, lung contusion in 8.13% patients, followed by haemothorax (7.32%), hemopneumothorax (5.70%) and pneumothorax (3.25%). Conservative management suffices in most cases (86.59%), tube thoracostomy in 12.19%, thoracotomy in 1.22% cases. Patients with VAS score of 6 and above required intercostal nerve block (5.31%) or epidural analgesia (2.45%) for satisfactory pain relief. Pneumonia and atelectasis were common complications 2.03% each. Mortality rate was 1.22%. Average length of hospital stay was 4.6 days.Conclusions: Chest trauma commonly affects young males with RTA causing significant morbidity and mortality. Majority of patients can be treated conservatively.

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Profile of ocular injuries amongst various trauma patients presenting to tertiary care centre of Punjab

Indian Journal of Clinical and Experimental Ophthalmology ◽

10.18231/j.ijceo.2021.129 ◽

2022 ◽

Vol 7 (4) ◽

pp. 642-647

Author(s):

Anubha Bhatti ◽

Arushi Kakkar ◽

Shakeen Singh

Keyword(s):

Traffic Accidents ◽

Ocular Trauma ◽

Road Traffic ◽

Tertiary Care ◽

Ocular Injury ◽

Trauma Patients ◽

Road Traffic Accidents ◽

Care Centre ◽

Tertiary Care Centre ◽

Trauma Society

To study the epidemiology and clinical profile of ocular trauma patients presenting to tertiary care centre. Prospective study. All patients of ocular trauma in OPD/Emergency were assessed for detail between 1/1/17 to 31/6/18 and data on demographic profile was established as per guidelines of Ocular Trauma Society of India. Patients were categorized in different segments and assessed/followed for visual impairment in particular. A total of 246 cases were examined out of which 87% were males. The most common mode of ocular injury was Road Traffic Accidents. Pediatric eye trauma constituted 16.7% of the total cases. 26.8% cases arrived to our centre between 4-24 hours and 62.6% cases presented after 24 hours. Amongst 131 cases of Road Traffic Accidents, none of them were using protective measures like helmets or goggles. Of these, 17.1% were under the influence of alcohol. 28.5% were involved in medicolegal proceedings. Majority of the cases comprised of monocular trauma (78.1%). Closed globe injuries constituted 88.94% of the total cases of which most cases presented with lid edema and ecchymosis. Chemical injuries were reported in 4.5% cases. 9 patients lost vision completely and 71 cases had vision from light perception to 6/18. Ocular trauma is one of the common causes of ocular morbidity. It has been seen predominantly in male population. Public needs to be educated about safety measurements and education about prompt need to specialised care to reduce ocular trauma related visual morbidity.

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Disability and mortality following road traffic injury: a follow-up study from a tertiary care centre of India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20175356 ◽

2017 ◽

Vol 4 (12) ◽

pp. 4712 ◽

Cited By ~ 1

Author(s):

Ashish Chauhan ◽

Naim Ahmed ◽

Jai Veer Singh ◽

Vijay Kumar Singh ◽

Ajai Singh ◽

...

Keyword(s):

Road Traffic ◽

Tertiary Care ◽

Road Traffic Injury ◽

Care Centre ◽

Tertiary Care Centre ◽

Lower Limb Injury ◽

Road Traffic Injuries ◽

Follow Up Study ◽

Traffic Injury

Background: Road traffic injury (RTI) is emerging as a huge public health problem throughout the world. The problem is magnified manifold as it mainly affects people in productive age-group causing significant mortality and disability. Very few studies have been done in India to assess disability following RTI though it has attained astronomic proportions. This study was undertaken to know the proportion of disability as an outcome amongst patients admitted for road traffic injuries in a tertiary care centre of Lucknow, India and to know the determinants of mortality and disability following Road Traffic Injuries amongst these patients.Methods: A follow-up study was conducted on 267 patients of RTI admitted at Trauma Centre of King George’s Medical University UP (tertiary care centre), Lucknow, India from November 2012 to June 2013. Systemic random sampling was used to select the patients. Disability was assessed using ten points modified Barthel index. Data analysis was done using SPSS 17.0 software.Results: Mortality and disability were seen in 13.1 percent and 16.36 percent of the patients. Residence locale, road user type, time at first aid and admission, and head injury were significantly associated with mortality while extremes of age, residence locale and lower limb injury were significantly associated with disability. The level of significance was set at p value of 0.05.Conclusions: RTI poses a huge burden on healthcare delivery system and society in the form of mortality and disability. Attempts pertaining various sectors should be made to reduce the incidence of RTI and ensuing disability.

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Epidemiology and Treatment Outcomes of Head Injury in Bangladesh: Perspective from the Largest Tertiary Care Hospital

Indian Journal of Neurotrauma ◽

10.1055/s-0040-1718780 ◽

2021 ◽

Author(s):

Sukriti Das ◽

Bipin Chaurasia ◽

Dipankar Ghosh ◽

Asit Chandra Sarker

Keyword(s):

Head Injury ◽

Road Traffic ◽

Head Injuries ◽

Skull Fracture ◽

Tertiary Care ◽

Acute Subdural Hematoma ◽

Care Hospital ◽

Female Ratio ◽

Mortality And Morbidity ◽

The Government

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity. Economic impact is much worse in developing countries like Bangladesh, as victims are frequently male, productive, and breadwinners of the families. Objectives The objective of our study was to highlight the etiological pattern and distribution of varieties of head injuries in Bangladesh and give recommendations regarding how this problem can be solved or reduce to some extent at least. Methods From January 2017 to December 2019, a total of 14,552 patients presenting with head injury at emergency got admitted in Neurosurgery department of Dhaka Medical College and Hospital and were included in this study. Results The most common age group was 21 to 30 years (36%: 5,239) with a male-to-female ratio of 2.6:1. Injury was mostly caused by road traffic accident (RTA [58.3%: 8,484]), followed by fall (25%: 3,638) and history of assault (15.3%: 2,226). The common varieties of head injury were: acute extradural hematoma (AEDH [42.30%: 1,987]), skull fracture either linear or depressed (28.86%: 1,347), acute subdural hematoma (ASDH [12.30%: 574]), brain contusion (10.2%: 476), and others (6.04%: 282). Conclusion RTA is the commonest cause of TBI, and among them motor bike accident is the severe most form of TBI. AEDH is the commonest variety of head injuries. Proper steps taken by the Government, vehicle owners, and drivers, and proper referral system and prompt management in the hospital can reduce the mortality and morbidity from TBI in Bangladesh.

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Pattern of major injuries after motorcycle accidents in Egypt: The Mansoura Emergency Hospital experience

Trauma ◽

10.1177/1460408616652924 ◽

2016 ◽

Vol 19 (1) ◽

pp. 39-45 ◽

Cited By ~ 2

Author(s):

El Yamani Fouda ◽

Mohamed Youssef ◽

Sameh H Emile ◽

Hossam Elfeki ◽

Waleed Thabet ◽

...

Keyword(s):

Road Traffic ◽

Head Injuries ◽

Age Groups ◽

Road Traffic Injuries ◽

Emergency Hospital ◽

Chest Injuries ◽

The Common ◽

Orthopedic Injuries ◽

Motorcycle Accidents ◽

Motorcycle Crashes

Background and aim Motorcycle accidents are one of the leading causes of road traffic injuries and mortality. The aim of this study was to determine the common patterns of major injuries associated with motorcycle accidents in patients attending Mansoura University Emergency Hospital in Egypt, and to measure the magnitude of the problem in our community. Patients and methods Patients involved in motorcycle crashes who were admitted to the hospital during August 2014 to April 2015 were retrospectively reviewed. All age groups and both genders were included. Results Two hundred patients (181 males) with a mean age of 30.7 ± 10.5 years were included with the majority of patients aged 20–40 years. Head injuries were the most frequent fatal injuries (9/61) patients; orthopedic injuries were the most common injuries, occurring in 78.5% of victims. Multisystem injuries occurred in 28% of patients. None of the motorcyclists involved in accidents wore helmets. Conclusion Motorcycle accidents are a common cause of road traffic injuries and mortalities in Egypt, occurring mainly in males aged 20–40 years. The majority of victims had an isolated trauma to single body system. Orthopedic injuries were the most common and least fatal type of injuries. The highest fatalities were among patients with chest injuries then patients with head injuries. None of the victims wore protective clothing or helmets at the time of accident.

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Histopathological Study of Lesions of the Nasal Cavity, Paranasal Sinuses and Nasopharynx in a Tertiary Care Centre, Visakhapatnam over a Period of 2 Years

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/557 ◽

2021 ◽

Vol 8 (33) ◽

pp. 3054-3059

Author(s):

Rajendra Prasad Jagannadham ◽

Lakshmi Latchupatula ◽

Sravani Ponnada ◽

Neelima Lalam ◽

Raghunadhababu Gudipudi ◽

...

Keyword(s):

Nasal Cavity ◽

Paranasal Sinuses ◽

Histopathological Examination ◽

Tertiary Care ◽

Histopathological Study ◽

Histopathological Diagnosis ◽

Malignant Tumours ◽

Tertiary Care Centre ◽

Female Ratio ◽

Male Predominance

BACKGROUND A variety of non - neoplastic and neoplastic conditions involve the nasal cavity, paranasal sinuses and nasopharynx and these are very common lesions encountered in clinical practice. Histopathological examination of these lesions is the gold standard for diagnosis because management and prognosis vary among different lesions. The aim of the present study was to evaluate the histopathological study of the lesions of the nasal cavity, paranasal sinuses and nasopharynx in relation to their incidence, age, gender and site wise distribution and to compare the results with the available data. METHODS A study of 88 cases was conducted for a period of 2 years from August 2017 to July 2019. After fixation, Processing and Haematoxylin and Eosin staining and special stains histopathological diagnosis was made. RESULTS Among 88 total cases, 58 were males and 30 were females. A male predominance was observed with a male to female ratio of 1.93 : 1. They were more common in third, fourth and fifth decade of life. Malignant nasal lesions were seen after fourth decade of life. Nasal lesions were more common in nasal cavity (67.05 %), followed by paranasal sinuses (18.18 %) and nasopharynx (14.75). Out of 88 total cases, 39 (44.32 %) were non - neoplastic, 30 (34.09 %) were benign and 19 (21.59 %) were malignant nasal lesions. CONCLUSIONS Sinonasal lesions and nasopharyngeal lesions can have various differential diagnoses. A complete clinical, radiological and histopathological correlation helps to categorize these sinonasal lesions into various non - neoplastic and neoplastic types. But histopathological examination remains the mainstay of definitive diagnosis. KEYWORDS Nasal Cavity, Paranasal Sinuses, Nasopharynx, Benign Tumours, Malignant Tumours, Histopathological Examination

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Impact of changing trends of treatment on outcome of cerebral gliosarcoma: A tertiary care centre experience

South Asian Journal of Cancer ◽

10.4103/2278-330x.149931 ◽

2015 ◽

Vol 04 (01) ◽

pp. 015-017 ◽

Cited By ~ 4

Author(s):

Kumar Narendra ◽

Tapesh Bhattacharyya ◽

Chanchalani Karan ◽

Praveen Shalunke ◽

B D Radotra ◽

...

Keyword(s):

Overall Survival ◽

Median Overall Survival ◽

External Beam Radiotherapy ◽

Tertiary Care ◽

Tertiary Care Centre ◽

Female Ratio ◽

Changing Trends ◽

Common Location ◽

Male Preponderance ◽

Radiotherapy Alone

Abstract Aim: To assess clinicopathological features and outcomes in patients of primary gliosarcoma with changing trends of treatment. Materials and Methods: Medical records were reviewed and data collected on primary gliosarcoma over a 5-year period (2009–2013) from the departmental case files. Results: A total 27 patients were included in this study. The median age of presentation was 54 years. There was a slight male preponderance, with male to female ratio of 1.25:1. The most common location of the tumor was temporal lobe (44.4%). Gross total resection was possible in 19 cases, near total excision was done in five cases, and only partial excision with decompression in three cases. Of the 27 patients, 80.8% patients received post-operative radical external beam radiotherapy of 60 Gy/30#/6 weeks. Concurrent and adjuvant temozolomide was used in 42.3% cases, depending on affordability and tolerance. Median overall survival was 9 months. On subgroup analysis, median overall survival in the radiotherapy plus temozolomide group was 10 months as compared to 9 months in the radiotherapy alone group; however, this was not statistically significant.(P = 0.244). Conclusion: Treating Gliosarcoma is a major therapeutic challenge for a clinician because of its poor prognosis, aggressive clinical behavior, rarity, and limited clinical experience. With surgery and concurrent chemoradiation, we were able to achieve a median overall survival of 9 months. Addition of temozolomide has shown a better trend in survival though it is not statistically significant.

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