Abstract
BackgroundThe aim of this study was to compare retrospectively the characteristics of chest injuries and frequencies of other, concurrent injuries in patients after earthquakes of different seismic intensity.MethodsWe compared the cause, type, and body location of chest injuries as well as the frequencies of other, concurrent injuries in patients admitted to our hospital after the Wenchuan and Lushan earthquakes in Sichuan, China. We explored possible relationships between seismic intensity and the causes and types of injuries, and we assessed the ability of the Injury Severity Score, New Injury Severity Score, and Chest Injury Index to predict respiratory failure in chest injury patients.ResultsThe incidence of chest injuries was 9.9% in the stronger Wenchuan earthquake and 22.2% in the less intensive Lushan earthquake. The most frequent cause of chest injuries in both earthquakes was being accidentally struck. Injuries due to falls were less prevalent in the stronger Wenchuan earthquake, while injuries due to burial were more prevalent. The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types. Spinal and head injuries concurrent with chest injuries were more prevalent in the less violent Lushan earthquake. All three trauma scoring systems showed poor ability to predict respiratory failure in patients with earthquake-related chest injuries.ConclusionsPrevious studies may have underestimated the incidence of chest injury in violent earthquakes. The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity. Earthquake severity and interval between rescue and treatment may influence the prevalence and types of injuries that co-occur with the chest injury. Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake-related chest injuries.
Highlights
In 2008, the devastating Wenchuan earthquake hit China’s Sichuan province and led to 69,181 deaths, 18,522 missing and 374,171 injured
Addressing this question ideally requires examining two earthquakes that differ in intensity but that affect similar geologic areas with similar types of populations and distributions, and in which the casualties were treated at similar medical facilities
West China Hospital of Sichuan University is roughly equidistant from the epicenters of both earthquakes and was unaffected; it provided medical treatment to more trauma patients in both disasters than other hospitals, altogether 4,092 patients in the Wenchuan earthquake and 400 in the Lushan earthquake
Summary
In 2008, the devastating Wenchuan earthquake hit China’s Sichuan province and led to 69,181 deaths, 18,522 missing and 374,171 injured. The Lushan earthquake was rated as 7.0 on the Richter scale with a maximum intensity of IX Both earthquakes occurred in geologically and demographically similar areas, providing an unusual opportunity to compare the prevalence and types of casualties in two earthquakes differing primarily in seismic intensity. These studies have not, addressed the question of whether the characteristics of chest injuries or co-occurring injuries vary with earthquake intensity Addressing this question ideally requires examining two earthquakes that differ in intensity but that affect similar geologic areas with similar types of populations and distributions, and in which the casualties were treated at similar medical facilities. The data collected at West China Hospital on patients treated in both earthquakes provide a unique opportunity to examine the effects of seismic intensity on injury characteristics Such comparisons may help predict the types of injuries likely to occur in earthquakes of given severity and help administrators allocate limited medical resources appropriately. The aim of this study was to compare retrospectively the characteristics of chest injuries and frequencies of other, concurrent injuries in patients after earthquakes of different seismic intensity
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