Profile Of Chest Injury in the Peri-COVID-19 Period: A Single Centre Series

Abstract

BACKGROUND: Chest traumas continue to constitute about 30% of all traumas and contribute to 25-50% of trauma-related deaths. COVID-19 has its primary pathophysiologies in the lung, and can worsen the morbidity and mortality of chest trauma if it occurs concomitantly. AIM: To Examine the profile and outcome of chest trauma across the peri-COVID-19 period. MATERIALS AND METHOD: A retrospective analysis of cases of chest trauma in the peri-COVID-19 period (mid-Nov 2019 to mid-March 2022) at GMC Doda. RESULTS: Eighty-five cases of chest trauma met inclusion criteria within the 28 months period, M:F = 7.5:1, age range 3-80years, mean age (38.60±17.40years) and median age of 37years. There were 54 (63.5%0) cases of blunt chest trauma and 31 (36.5%) cases of penetrating chest trauma. Thirty-one (36.5%) patients sustained haemothorax, 9 (10.6%) pneumothorax, 14 (16.5%) haemopneumothorax, 21 (24.7%) rib fractures, and 10 (11.8%) chest wall lacerations. Fifty-one (60%) patients had isolated chest trauma while the remaining 34 (40%) had associated injuries in one or more other organ systems. Closed thoracostomy tube drainage was definitive treatment in 48 (56.5%) patients while emergency thoracotomy was done in 5 (6%) patients. The treatment administered in the remaining 32 (37%) patients included intercostal nerve block for chest pain from rib fractures, wound exploration and wound repair. In the series, 75 (88%) had complete recovery, six (7%) patients left against medical advice, and four (5%) in-hospital mortality was recorded. CONCLUSION: The profile of chest trauma in the peri-COVID-19 period in our centre differed from the pre-COVID-19 years with a higher mortality figure. Management protocol also necessitated certain modifications.