Abstract
Severe thoracic trauma is one of the major causes of injury-related mortality. In the United States, thoracic trauma results in one-fourth of all trauma deaths. Globally, cardiothoracic trauma is also a major contributor to mortality. The most common cardiothoracic injuries include rib fractures, thoracic vertebral fractures, haemothorax, pneumothorax, flail chest, and lung contusions. The purpose of the present study was to determine the survival rate of patients with cardiovascular injuries in road traffic accidents and its relationship with ISS, GCS and blood transfusions at King Khalid Hospital. This study is a useful addition to the literature, as research in this topic is lacking. A total of 189 patients were transported to the hospital with cardiothoracic injuries during the study period. Data was gathered regarding age, gender, nationality, vehicle user type, anatomical region injured, Intensive Care Unit (ICU) admission, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), blood transfusion, treatment and mortality rate. The neurological status was assessed using the GCS score. Injury Severity Scores were calculated to categorize the injury severity. The mean patient age was 31.81 years, with a peak age of between 21–30 years. Males predominated (93.7%) with a male to female ratio of 15:1. Most of the patients were Saudi nationals (61.3%). Overall mortality was 7.9%. Factors that were significantly associated with mortality were head and neck involvement, ICU admission, age (above 60), treatment delivered, and blood transfusions. Cardiothoracic trauma is associated with a high mortality rate, which may depend on the clinical presentation such as GCS, ISS, degree of shock, pattern of injuries, and associated injuries. Immediate management is vital for patients with life-threatening cardiothoracic trauma, as mortality is high if the diagnosis is missed, wrong or left untreated.
Highlights
Survival Rate of Patients with Cardiothoracic Injuries in Road Traffic Accidents, and their Relationship with Injury Severity Score (ISS), Glasgow Coma Scale (GCS) and blood transfusions
MATERIALS AND METHODS A hospital-based cross-sectional retrospective study was carried out at King Khalid Hospital and Prince Sultan Center for Health Services (KKH & PSCHS) from January 01, 2012 to December 31, 2017, to assess the survival rate of patients with cardiothoracic injuries resulting from road traffic accidents (RTA), and correlations with the Glasgow Coma Scale (GCS), the Injury Severity Score (ISS) and blood transfusions
The study subjects were selected based on the following inclusion criteria: 1 – Patients with cardiothoracic injuries. 2- Patients with injuries caused by a road traffic accident (RTA). 3- Patients with a hospital stay of more than 24 hours during the period of the study
Summary
Survival Rate of Patients with Cardiothoracic Injuries in Road Traffic Accidents, and their Relationship with ISS, GCS and blood transfusions. The purpose of the present study was to determine the survival rate of patients with cardiovascular injuries in road traffic accidents and its relationship with ISS, GCS and blood transfusions at King Khalid Hospital. Виживання пацієнтів з кардіоторакальними травмами при дорожньо-транспортних пригодах та їх зв'язок з ШТТ, ШКГ та переливанням крові. Мета цього дослідження полягала у визначенні показників виживання пацієнтів з серцевосудинними травмами в дорожньо-транспортних пригодах та їх зв'язку з ШТТ, ШКГ та переливанням крові в лікарні короля Халіда. The conditions, which require immediate emergency management for patients with cardiothoracic trauma include airway obstruction, massive haemothorax, tension pneumothorax, open pneumothorax, flail segment and cardiac tamponade, cardiac dysfunction, and injury to large intra-thoracic vessels. Lifethreatening conditions may require urgent surgical interventions, such as removal of a foreign body from the airway, chest tube insertion, and fluid or blood resuscitation in hypovloemic shock
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