Epidemiology and Impact of Thoracic Trauma on the Mortality of Multi-trauma Patients: Results From a French Road Trauma Registry 1997-2016

Abstract Thoracic trauma is the third most common cause of death in multi-trauma patients. One of the most frequent mechanism is road traffic accident (RTA). The objective of the present study was to investigate the influence of severe (abbreviated injury scale, AIS≥3) injuries in each body region on the mortality of multi-trauma patients with a particular attention to thoracic trauma. We also described the epidemiology and injury pattern of these patients when presenting with at least one AIS ≥2 thoracic injury (AISThorax≥2). Patients included in the Rhône RTA registry between 1997 and 2016, with at least one AIS ≥2 injury in any body region were included. Two subgroups were defined according to whether patients presented at least one AISThorax≥2 injury or not. Multivariate regression analysis with mortality as outcome was performed. A total of 46,526 patients had at least one AIS≥2 injury, among them 6,382 (13.7%) had at least one AISThorax≥2 injury. Severe thoracic injuries (OR=12.2, 95%CI [8.4;17.7]) were strongly associated with death, second to severe head injuries were (OR=26.8, 95%CI [20.4;35.2]). Chest wall injuries were the most frequent thoracic injury (62.1%, n=5,419) and 52.4% of these were multiple rib fractures. Severe thoracic injury is a priority in multi-trauma patients; both in the detection but also in the management.

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Impact of Thoracic Trauma on the Mortality of Multi-trauma Patients: It Matters - Results From a French Road Trauma Registry 1997-2016

10.21203/rs.3.rs-682244/v1 ◽

2021 ◽

Author(s):

Axel Benhamed ◽

Amina Ndiaye ◽

Thomas Lieutaud ◽

Marion Douplat ◽

Amaury Gossiome ◽

...

Keyword(s):

Thoracic Trauma ◽

Road Traffic ◽

Young Patients ◽

Significant Risk ◽

Primary Objective ◽

Thoracic Injury ◽

Body Region ◽

Trauma Patients ◽

Severe Injuries ◽

Rural Road

Abstract BackgroundThoracic trauma is the third most common cause of death in multi-trauma patients and is associated with poor short-term outcomes since it is responsible for up to 25% of trauma-related deaths. One of the most frequent mechanism is road traffic accident (RTA), affecting particularly young patients. The primary objective of the present study was to investigate the influence of severe injuries in each body region on the mortality of multi-trauma patients with a particular attention to thoracic trauma. Secondary objectives were to investigate risk factors for mortality in multi-trauma patients but also to describe the epidemiology and injury pattern of these patients when presenting with at least one abbreviated injury scale (AIS) ≥2 thoracic injury (AISThorax≥2).MethodsRetrospective study that included RTA occurring from January 1997 to December 2016. Patients of all ages included in the Rhône RTA registry, with at least one AIS ≥2 injury in any body region were included. Two subgroups were defined according to whether patients presented at least one AISThorax≥2 injury or not. Multivariate regression analysis with mortality as outcome was performed. ResultsA total of 46,526 patients had at least one AIS≥2 injury, among them 6,382 (13.7%) had at least one AISThorax≥2 injury. In the AISThorax≥2 group, the median [IQR] ISS was 14 [6-7] and 16.2% (n=1,031) patients died. Severe (AIS≥3) head (OR=26.8, 95%CI [20.4;35.2]) and thoracic (OR=12.2, 95%CI [8.4;17.7]) injuries were associated with death; as was age [40-59 years (OR=1.3, 95%CI [1.1;1.5]), 60-79 years (OR=2.1, 95%CI [1.7;2.6]), and ≥80 years (OR=5.5, 95%CI [4.2;7.3])], male sex (OR=1.5, 95%CI [1.3;1.7]), RTA occurring in a highway (OR=1.9, 95%CI [1.5;2.4]) or in a rural road (OR=1.8, 95%CI [1.5;2.1]). The most frequent thoracic injury was that of the chest wall (62.1%, n=5,419). The most frequent concomitant AIS≥2 injuries affected the head (29.1%), upper extremities (26.8%), and lower extremities (25.8%).ConclusionsThe present study found that the severity of thoracic trauma was an independent and significant risk factor for death in multi-trauma patients as was age, being a car occupant and having a crash in a rural road or a highway.

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Does Fracture Pattern Influence Thoracic Trauma?

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633075 ◽

1992 ◽

Vol 05 (03) ◽

pp. 90-92 ◽

Cited By ~ 5

Author(s):

J. Dyce ◽

J. E. F. Houlton

Keyword(s):

Significant Relationship ◽

Clinical Management ◽

Road Traffic Accident ◽

Traffic Accident ◽

Thoracic Trauma ◽

Road Traffic ◽

Fracture Pattern ◽

Fracture Repair ◽

Thoracic Wall ◽

Thoracic Injury

SummaryThe case records of 300 dogs presented for fracture repair following road traffic accident (RTA) or other trauma were studied to determine possible relationships between specific patterns of skeletal trauma and the prevalence of thoracic wall and pulmonary injury.A significantly greater proportion of dogs involved in RTA (31%) sustained thoracic trauma compared ro those injured by other means (2.4%). Although RTA cases were more likely to suffer multiple fractures (23%), there was no significant relationship between the incidence and distribution of a fracture(s) and radiographic evidence of thoracic trauma.Of those dogs with thoracic trauma, pneumothorax and pulmonary contusion were the most frequent injuries; more than one type of injury occurred in 43% of these cases.Clinical management was altered as a result of thoracic injury in 24% of these cases.In a retrospective survey of 300 dogs presented for fracture repair, there was no significant relationship between fracture pattern and the prevalence of thoracic trauma. Following road traffic accident, radio-graphic examination revealed thoracic trauma in 31% of dogs. Clinical management was modified as a result of thoracic injury in 24% of cases.

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Hypoglycaemic Shock: Normal or Abnormal Response to Injury?

Tropical Doctor ◽

10.1177/004947559802800319 ◽

1998 ◽

Vol 28 (3) ◽

pp. 177-178

Author(s):

R O Ofiaeli ◽

C C Anyaegbu ◽

C E Dioka

Keyword(s):

Road Traffic Accident ◽

Traffic Accident ◽

Road Traffic ◽

Metabolic Response ◽

Rib Fractures ◽

Trauma Patients ◽

Lumbar Region ◽

Profuse Sweating ◽

Multiple Rib Fractures ◽

Abnormal Response

We report a case of hypoglycaemic shock which occurred in a patient 18 h after injury. The patient was involved in a road traffic accident and sustained multiple rib fractures and bruising in the (R) lumbar region. Eleven hours after his last meal he developed sudden weakness, profuse sweating, air hunger, thirst, disorientation and suddenly lapsed into coma 18 h after admission. Administration of 50 ml of 50% dextrose resulted in immediate restoration of consciousness. This case shows that this complication can occur in trauma patients even though the metabolic response to trauma is usually assumed to be hyperglycaemic.

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Thoracic trauma in small animals: road traffic accidents

The Veterinary Nurse ◽

10.12968/vetn.2021.12.1.15 ◽

2021 ◽

Vol 12 (1) ◽

pp. 15-19

Author(s):

Kate Sheard

Keyword(s):

Traffic Accidents ◽

Thoracic Trauma ◽

Road Traffic ◽

Positive Outcome ◽

Multiple Organ ◽

Trauma Patients ◽

Small Animals ◽

Road Traffic Accidents ◽

Blunt Force Trauma ◽

Organ Systems

Thoracic trauma is common in small animals and can be caused by a variety of insults from penetrating wounds to blunt force trauma. Patients that have sustained any form of thoracic trauma require immediate attention and intensive nursing care in order to have a positive outcome for the patient. These cases can prove challenging as multiple organ systems can be affected and surgery is often required. However, combined with the appropriate medical care, the outcome can be successful.

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Epidemiological study of fatal road traffic accident cases

Indian Journal of Forensic and Community Medicine ◽

10.18231/j.ijfcm.2021.051 ◽

2021 ◽

Vol 8 (4) ◽

pp. 255-257

Author(s):

O Gambhir Singh

Keyword(s):

Epidemiological Study ◽

Traffic Accident ◽

Road Traffic ◽

Head Injuries ◽

Case Fatality ◽

Lower Limbs ◽

Care Centre ◽

Health Care Centre ◽

Female Ratio ◽

Male Female Ratio

The present study is an epidemiological study of fatal Road Traffic (RTA) cases brought and admitted in our tertiary health care centre from Nov 2017 to December 2019. There were 148 fatal RTA cases involving 112 males and 36 female. In the present study males cases outnumbered the female with an approximate male female ratio of 3.1:1. Many cases of fatal head injuries were due to four & two wheelers. Most commonly seen external injuries were abrasions. Lower limbs showed fractured in 31 cases, 20.95%, and upper limbs showed fractured in 22 cases, 14.89%. So, far case fatality is concerned involvement of head plays the most important role.

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A prospective study of chest injuries and associated complications with special reference to surgical emphysema

International Surgery Journal ◽

10.18203/2349-2902.isj20180482 ◽

2018 ◽

Vol 5 (3) ◽

pp. 873

Author(s):

Sunil Kumar Dangi ◽

Naresh Meena ◽

Ashok Parmar

Keyword(s):

Thoracic Trauma ◽

Road Traffic ◽

Bone Fractures ◽

Flail Chest ◽

Pulmonary Contusion ◽

Long Bone ◽

Trauma Patients ◽

Thoracic Injuries ◽

Female Ratio ◽

Surgical Emphysema

Background: Chest trauma (or thoracic trauma) is a serious injury of the chest. Thoracic injuries may present extremely dramatic clinical problem that demand rapid diagnosis, decision making and aggressive management. Thoracic injuries can range from simple single rib fracture to major thoracic vessel injury and pulmonary contusion.Objective of this study was to describe the clinical characteristics and risk factors of thoracic trauma patients, and to evaluate their relationship in the development of complications with special emphasis to surgical emphysema.Methods: Descriptive, prospective and analytical study of a cohort of patients with thoracic trauma who were followed up for a period of 30 days. Excluded from the study were those patients with moderate to severe cranio-encephalic trauma, long bone fractures, abdominal trauma, and patients who required mechanical ventilation.Results: A total of 102 patients met the inclusion criteria out of which 90(88.23%)patients were male and 12(11.77%) female with male to female ratio of 7.5:1. Patients having surgical emphysema were all male 21(21.56%). Most common mode of the injury seen was road traffic accidents in 80 (80.95%) patients, followed by assault in 9(9.52%) patients, bull horn injury and fall from height in 4(4.76%) patients. Other chest injury which was most commonly associated with surgical emphysema was haemothorax in 11(52.38%) patients, followed by pneumothorax in 7(33.33%) patients, pulmonary contusion in 6(28.57%) patients and flail chest in 3(14.26%) patients. The risk of complications increases significantly in patients with more than 2 rib fractures, in older patients and in the presence of some comorbidities such as COPD and pathologies that require anticoagulation. The risk of re-admittance is greater in patients older than 60 years.Conclusions: Patients with thoracic trauma who present with co-morbidities, are older than 60 years and have more than 2 ribs fractures may present with more complications. These factors should be contemplated in the evaluation, management and follow-up of these subjects.

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Profile of head injuries in Road Traffic Accident cases with Ocular trauma in a rural tertiary care hospital

Indian Journal of Clinical and Experimental Ophthalmology ◽

10.5958/2395-1451.2015.00022.0 ◽

2015 ◽

Vol 1 (4) ◽

pp. 245

Author(s):

Sandhya Ramachandra ◽

Sai sushma Yeturu ◽

Chandrakant Pujar ◽

Spoorthy Sagara ◽

Sameera Nikhil Veerakanellore ◽

...

Keyword(s):

Road Traffic Accident ◽

Traffic Accident ◽

Ocular Trauma ◽

Road Traffic ◽

Tertiary Care Hospital ◽

Head Injuries ◽

Tertiary Care ◽

Care Hospital

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Profile of Fatal Road Traffic Accident Cases in Srikakulam District - An Autopsy-Based Study

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/621 ◽

2020 ◽

Vol 7 (50) ◽

pp. 3046-3049

Author(s):

Sadhu Rama Mohana Rao ◽

Avvaru Krishnaveni ◽

Reddi Bindu ◽

Ronanki Mounika

Keyword(s):

Road Traffic Accident ◽

Traffic Accident ◽

Traffic Accidents ◽

Road Traffic ◽

Head Injuries ◽

Public Health Problem ◽

Global Public Health ◽

Road Traffic Accidents ◽

Chest Injuries ◽

Wrong Side

BACKGROUND Road Traffic Injuries (RTA's) are a major but neglected global public health problem requiring concerted efforts for effective and sustainable prevention. Road traffic accident is one of the major causes of morbidity and mortality in developing countries, including India. Srikakulam is the northern district in Andhra Pradesh state which has 194 kilometres of National Highway (NH) passing through it from Ichapuram to Pydibheemavaram. Frequent median openings, poorly designed access roads from the adjacent areas of highways and lack of effective enforcement to control wrong side vehicular movements on NH16 have led to an increase in number of road accidents in this region. We wanted to study the demographic distribution of cases, assess the nature and cause of deaths certified after post-mortem examinations, and evaluate the pattern and distribution of injuries associated with road traffic accidents. METHODS It is a record-based study, a total of 422 autopsies done in the year 2019 were studied, of which 131 were due to RTA's. Data regarding 131 RTA's was analysed using the records available with the Forensic Medicine department. Institutional Ethical Committee (IEC) approval was taken. RESULTS In our study, 78 % were men, and 22 % were women. 41 - 60 years age group showed the highest number of victims (38 %) (49). Head injuries were most common (54.6 %), followed by multiple injuries (27.6 %) and chest injuries (8.4 %). The study reported more accident-related deaths during the month of May (22 %), followed by April (11.4 %). CONCLUSIONS Head injuries and subdural & sub arachnoid hematoma are the leading causes of death from RTAs. KEYWORDS Autopsy, Cause of Death, Fatal Road Traffic Accidents, Injuries, Pattern of Injuries

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