Chest Trauma at the Emergency Department of the Gabriel Tour&amp;#233; University Hospital Bamako, Mali

Almeimoune Abdoulhamidou,Diallo Boubacar,Harouna Sangare,Sidy Yattara,Mangane Moustapha,Abdoulaye Chiad Mahamadoun Cisse,Yoro B Sidibe,Amadou Bah,Diop Madane Thierno,Démbele Seidou Alaji,Diango Djibo Mahamane,Kassogue André,Ogalat Enyengue Murielle Ingrid,Sogoba Youssouf,Coulibaly Mahamadoun,Madiassa Konaté

doi:10.4236/ojem.2021.92003

Abstract

In Mali, chest injuries remain a real public health problem and are associated with heavy morbidity and mortality. Faced with a resurgence of urban civil violence and the explosion of road accidents, we decided to conduct this study in order to describe the epidemiological, clinical and therapeutic aspects of thoracic trauma in the emergency department. Method and Material: This is a descriptive prospective study over a period of one year in the emergency department of the CHU Gabriel Toure. Including all patients admitted for thoracic trauma. Analysis and Entry: Data were entered and analyzed on SPSS software version 20.0. The test was significant for a p value < 0.05. Results: We recorded 21,090 appeals in our structure among which 1284 patients were suspected of thoracic trauma. The diagnosis of thoracic trauma was retained in 119 (0.56%) patients. All patients were transported to the emergency room without prehospital medicalization. Clinical presentation was dominated by dyspnea in 54.6% of patients, however pain was the almost constant symptom in conscious victims. Various traumatic mechanisms had caused these lesions of the thorax, of which road traffic accidents represented half of the causes, followed by urban civil violence in 28.6% of patients. Landslides and falls from a great height were responsible for 19.5% of chest injuries. Open chest trauma was the type of lesion found in a third of the cases. This type of injury was exclusively due to blows and injuries during the brawls. Standard chest radiography was performed as the first intention in 60% of patients compared to 10.9% for the pleuropulmonary ultrasound. Thirteen patients required ventilatory assistance after orotracheal intubation. The average length of stay was 65.23 hours. During the period of our study, the overall mortality was 1.85% in the emergency departments with a lethality specific to chest trauma of 15%. Conclusion: Urban violence with its share of ballistic wounds determined the severity of this condition.

Highlights

Faced with a resurgence of urban civil violence and the explosion of road accidents, we decided to conduct this study in order to describe the epidemiological, clinical and therapeutic aspects of thoracic trauma in the emergency department
Open chest trauma was the type of lesion found in a third of the cases
The diagnosis of thoracic trauma was retained in 119 patients, that is to say an incidence of 0.56%

Summary

Introduction

Hemopneumothorax is one of the most common, with a prevalence of 52.3%, followed by hemothorax (23.4%) and pneumothorax 20.7%) [2] These severe injuries are clinically relevant to the multiple-injured patient as they affect respiratory mechanics, increasing the work of breathing and making it difficult for patients to effectively ventilate on their own. In Mali, chest trauma is a real public health problem and is associated with heavy morbidity and mortality [5] [6]. These high-velocity traumas largely explain their injury mechanism. Faced with a resurgence of urban civil violence, the explosion of road accidents, and the increase in gunshots and injuries, we decided to conduct this study in order to describe the epidemiological, clinical, and therapeutic aspects of thoracic trauma

Methods

Results

Conclusion