Okoye Onyedika Godfrey, Olaomi Oluwole Olayemi, Adamu Yahaya Baba, Anumenechi Ndubisi
Trauma Centre, Department of Surgery, National Hospital Abuja, Central Business District, Garki, Abuja, Nigeria.
Cardiothoracic Division, Department of Surgery, National Hospital Abuja, Nigeria.
Afr J Emerg Med. 2023 Mar;13(1):15-19. doi: 10.1016/j.afjem.2022.12.002. Epub 2023 Jan 12.
Trauma is the leading cause of death in individuals between the ages of 1 and 44 years and it is the third commonest cause of death regardless of age. Thoracic trauma is a relatively common cause of preventable death among trauma patients. The spectrum of injuries after blunt chest trauma presents a challenging problem to the emergency physician. This study is intended to discuss the epidemiology, severity and initial management strategies in chest trauma patients, in a low income country.
A cross sectional retrospective study among chest trauma patients seen in the emergency room of National Hospital Trauma Centre, Abuja, Nigeria, from January 2015 to December 2017. Relevant patients' information was retrieved from the trauma registry kept in the trauma centre. Data processing and analysis was done using statistical package for social sciences (SPSS) version 24. Test of significance was done where applicable using chi square and student t test, using p value less than 0.05 as significant. Results are presented in tables and figures.
A total of 637 patients, male to female ratio of 3.6 and mean age of 34.18 ± 11.34 were enrolled into the study. The most common mechanisms of injury were MVC (54.6%) and assault (23.5%). Blunt injuries were 3.5 times more frequent than the penetrating injuries. The RTS of 12 (76.3%) and the ISS of 1-15 category (52.3%) were the most common scores. Up to 98% of patients were managed non-operatively. Recovery rate was high (89%) with relatively low mortality rate of 4.2%.
Majority of thoracic trauma can be managed effectively by employing simple, non-operative procedures such as needle decompression and chest tube insertion. Efforts should be made to include these procedures in the skill set of every medical officer working in the emergency room, particularly in low and middle income countries where there is paucity of emergency physicians.
创伤是1至44岁人群死亡的首要原因，无论年龄大小，它都是第三大常见死因。胸部创伤是创伤患者中可预防死亡的相对常见原因。钝性胸部创伤后的损伤谱给急诊医生带来了一个具有挑战性的问题。本研究旨在探讨低收入国家胸部创伤患者的流行病学、严重程度及初始管理策略。
对2015年1月至2017年12月在尼日利亚阿布贾国家医院创伤中心急诊室就诊的胸部创伤患者进行横断面回顾性研究。从创伤中心保存的创伤登记册中检索相关患者信息。使用社会科学统计软件包（SPSS）24版进行数据处理和分析。在适用的情况下，使用卡方检验和学生t检验进行显著性检验，以p值小于0.05为有显著性。结果以表格和图表形式呈现。
共有637例患者纳入研究，男女比例为3.6，平均年龄为34.18±11.34岁。最常见的损伤机制是机动车碰撞（MVC，54.6%）和袭击（23.5%）。钝性损伤的发生率是穿透性损伤的3.5倍。最常见的评分是创伤评分（RTS）为12分（76.3%）和损伤严重度评分（ISS）为1 - 15级（52.3%）。高达98%的患者接受非手术治疗。恢复率高（89%），死亡率相对较低，为4.2%。
大多数胸部创伤可通过采用简单的非手术程序（如针吸减压和胸腔闭式引流）有效处理。应努力将这些程序纳入在急诊室工作的每位医务人员的技能组合中，特别是在急诊医生短缺的低收入和中等收入国家。
