van Aswegen Heleen, Roos Ronel, Svensson-Raskh Anna, Svensson Annie, Sehlin Maria, Caragounis Eva-Corina, Plani Frank, Fagevik-Olsén Monika
Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
Eur J Trauma Emerg Surg. 2025 Jan 16;51(1):21. doi: 10.1007/s00068-024-02753-y.
Thoracic trauma causes pain and hospitalisation. Middle- and high-income countries have different trauma contexts and populations. To report patients' clinical presentation (pain and shortness of breath) and its influence on hospital length of stay (LOS), acute care management, and discharge destinations in South Africa (SA) and Sweden.
Prospective observational multicenter study by means of clinical record review. Two centers in SA and four centers in Sweden participated. One thousand nine hundred and eighteen adults with thoracic trauma were screened over the 20 months period. Study objectives guided information retrieved from clinical records. Statistical analysis was done with significance at p-value < 0.05.
Three-hundred-sixty-four participants were recruited with most being male (n = 170/179 (95%) SA; n = 125/185 (68%) Sweden). Type and mechanism of injury differed (SA penetrating (82%) versus Sweden blunt (95%); SA assaults (90%) versus Sweden falls (44%)). Unilateral haemopneumothorax was common (SA 68%, Sweden 35%) and managed with intercostal drainage. Rib cage injuries were common in the Swedish cohort with rib fixation surgery for 17%. Physiotherapy treatment frequency was mostly daily. Blunt injury resulted in higher pain levels during deep breathing (day 1: p = 0.014; day 2: p < 0.001; day 3: p < 0.001) and shortness of breath during activity (day 1: p = 0.036; day 2: p = 0.003; day 3: p < 0.001). LOS was shorter for SA cohort (5 (± 4) versus 7 (± 5) days; p = 0.024). Age influenced LOS in the blunt injury group. Discharge destination was mostly home (99% SA, 56% Sweden).
Priority care is indicated for those who are older and have blunt thoracic injury to prevent pulmonary complications and prolonged hospitalisation.
胸部创伤会导致疼痛和住院治疗。中高收入国家的创伤情况和人群各不相同。报告南非（SA）和瑞典患者的临床表现（疼痛和呼吸急促）及其对住院时间（LOS）、急性护理管理和出院目的地的影响。
通过临床记录回顾进行前瞻性观察性多中心研究。南非的两个中心和瑞典的四个中心参与了研究。在20个月期间对1918名成年胸部创伤患者进行了筛查。研究目标指导从临床记录中检索信息。采用p值<0.05的显著性进行统计分析。
招募了364名参与者，其中大多数为男性（南非：n = 170/179（95%）；瑞典：n = 125/185（68%））。损伤类型和机制不同（南非穿透伤（82%）与瑞典钝性伤（95%）；南非袭击伤（90%）与瑞典跌倒伤（44%））。单侧血气胸很常见（南非68%，瑞典35%），采用肋间引流进行处理。瑞典队列中肋骨骨折损伤很常见，17%进行了肋骨固定手术。物理治疗频率大多为每天一次。钝性伤导致深呼吸时疼痛程度更高（第1天：p = 0.014；第2天：p < 0.001；第3天：p < 0.001）以及活动时呼吸急促（第1天：p = 0.036；第2天：p = 0.003；第3天：p < 0.001）。南非队列的住院时间较短（5（±4）天对7（±5）天；p = 0.024）。年龄影响钝性伤组的住院时间。出院目的地大多是回家（南非99%，瑞典56%）。
对于年龄较大且有钝性胸部损伤的患者，应给予优先护理，以预防肺部并发症和延长住院时间。
