Traumatic chest injury in children: A single thoracic surgeon′s experience in two Nigerian tertiary hospitals

Okonta, Kelechi E.

doi:10.4103/0189-6725.170193

Cited by 8 publications

(12 citation statements)

References 18 publications

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“…Some studies in the country alluded to this. 28,29 A study with a good number of BCI resulting from falls, also showed an increased fracture of bones of the extremity. 10 The reason given in my previous, and this study was the deployment of the limbs as a protective reflex action.…”

Section: Discussionmentioning

confidence: 99%

“…10 The reason given in my previous, and this study was the deployment of the limbs as a protective reflex action. 28 Also, blunt abdominal injuries leading to exploratory laporatomies were the commonest associated injuries in significant number of patients with BCI.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have pointed out the seasonal occurrence of trauma. [26][27][28] The incidence of blunt chest injury is related to the number of motor vehicular accidents and thus the incidence is decreased with reduction in motor vehicular accidents. 2 and conversely, increased with increased motor vehicular accidents.…”

Section: Discussionmentioning

confidence: 99%

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Blunt Chest Injury: epidemiological profile and determinant of mortality

Okonta¹,

Ocheli²

2018

Int Surg J

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Background: The identification of the epidemiological profile and the determinants of mortality for blunt chest injuries (BCI) ensures the proper documentation of susceptible patients, and the implementation of strategies for prompt and improved patients’ care.Methods: This is a prospective study for a 4-year period at two tertiary hospitals in Nigeria. The inclusion criteria were patients who had BCI, did chest radiograph and admitted for treatment. The statistical software for analysis was SPSS version 22 and using Pearson’s X2 and spearman’s X2 for correlation of mortality with the Injury Severity Score (ISS), Glasgow Coma Scale(GCS) and Hemi-thorax affected. The p-value was significant at <0.001.Results: I One-hundred and twenty-six (52.3%) of 241 patients had BCI, the average age was 40.4years with a range of 0.8-79years.There were 104 (82.5%) male with a ratio of 4.7:1. Most patients 86(68.3%) were between 19-59 years of age, 85 (67.5%)were unskilled workers and 57 (45%) had no formal education. Most 66.7% of the injuries occurred in the first half of the year with a peak (16.3%) in March. Mondays and Fridays,and, morning hours were the peak periods. BCI was by motor vehicular accidents 94 (74.6%), falls 28 (22.2%), and other causes 4 ((3.2%). The associated injuries were extremities 25(19.8%,), cranio-spinal injuries 17(13.5%) and blunt abdominal injuries13 (10.3%). Eleven (8.7%) patients died within one-month of admission. The determinants of mortality were high ISS (p<0.001), severe head injury (p<0.001) and bilateral chest injury (p<0.001).Conclusions: The contribution of falls to BCI is on the increase with BCI occurring at periods of increased activities like Mondays, Fridays and morning hours.The determinants of mortality were high ISS ,severe head injury and bilateral chest injury.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Blunt Chest Injury: epidemiological profile and determinant of mortality

Okonta¹,

Ocheli²

2018

Int Surg J

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“…It has been reported that the commonest thoracic structure affected in chest injury is the rib, leading to rib fracture because of the increased calcium deposition in this age group as against children whose ribs are elastic and not commonly fractured. [11][12][13] The clinical significance of rib fracture in the elderly is to show the degree of intra-thoracic organ involvement, determinant for worsening lung pathology, may subsequently be a source of chronic chest pain and indicate the severity of injury. 14 The patients with fracture more than 3 ribs showed increased morbidity and mortality than those patients with fracture of 3 ribs or less.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Most elderly patients have accompanying co-morbid factors, of which diabetes caused adverse hospital outcomes, and again trauma in the elderly has all the poor indices with regards to morbidity, however it does appear from present study and studies elsewhere that prolonged hospital stay occurred more than other known complications like empyema thoracic as reported in children. 11,15 The mortality of 7.9% can be said to be low when considering the high injury severity scores the patients presented with. There are some reasons that ensured that low mortality rate from chest trauma in the old and elderly patients were recorded.…”

Section: Discussionmentioning

confidence: 99%

Chest trauma in the older people: epidemiological profile and treatment outcome

Okonta

Ocheli

2018

Int Surg J

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Background: There has not been any documented account of chest trauma among the older persons in Nigeria. The aim is to determine the epidemiological profile of chest injury in the old population. Methods: A prospective study of all the patients with chest trauma in two Nigeria tertiary hospitals for 4 years period. The bio-data, cause and type of chest injury, time between injury and presentation in the hospital, number of rib fractures, associated injury, injury severity score (ISS), treatment and outcome were analyzed using range and mean. Results: A total of 38(15.8%) older persons of 241 patients with chest trauma were analysed. Twenty-two (57.9%) patients were male with most of the patients being farmers and unskilled workers. Twenty-four (63.2%) patients sustained chest injury from motor vehicular crash while 10(26.3%) patients were from falls,2(5.3%) patients from gunshot injury and 2(5.3%) patients from other causes. The time between injury and presentation to the hospital ranged from 30-minutes to 5-days. Twenty-seven patients (71.1%) had rib fracture. The associated injuries were limb bone injuries in 10 (26.3%) patients, blunt abdominal injuries in 2(5.3%) patients and neurological injuries in 4 (10.6%) patients. The treatment in 35 (92.1%) patients was at least by chest tube insertion. The 30-day hospital mortality was 3(7.9%) from patients with injury severity scores of 32, 41 and 48 respectively. Conclusions: Traumatic chest injury in the older persons is still not common. Trauma to the limb bones was the commonest associated injury, and rib fracture was the commonest thoracic injury encountered. However, expeditious management led to reduced mortality recorded in this study.

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Breaking point? An analysis of fatal stab wounds to the torso in Ireland between 2011 and 2018, examining the extent of rib fractures

Bourke,

McCartney,

Greene

et al. 2023

Journal of Forensic Sciences

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This study examines the pattern of rib injuries occurring in cases of fatal torso stab wounds in Ireland between 2011 and 2018. It has been suggested by previous studies that rib fractures are not commonly sustained in stab wounds to the torso. We wanted to ascertain whether this was the case, as our data suggested that rib fractures were frequent, and where a rib is fractured there is a higher chance of organ injury and death, making this an important area of study. One hundred and forty seven cases of fatal stab wounds from an eight‐year period were retrospectively reviewed. Fatal stab wounds to other body areas, were excluded; leaving a total of 104 cases with stab wounds to the torso. We found that 69.2% of cases had rib injuries, a figure significantly higher than previously reported. Our data suggests that stab wounds to the torso often fracture ribs, putting the underlying organs at increased risk of injury and perhaps contributing to fatality. The amount of force needed to cause a rib fracture can be difficult to quantify and indeed from the high percentage of rib fractures sustained in our data it appears that the ribs may be fractured regardless of the amount of force used; this is borne out by the finding that self‐inflicted injuries also caused rib fractures. Our study shows that other factors, such as anatomical positioning and wound depth may have a greater bearing than force in terms of whether a rib fracture is sustained.

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Traumatic chest injury in children: A single thoracic surgeon′s experience in two Nigerian tertiary hospitals

Cited by 8 publications

References 18 publications

Blunt Chest Injury: epidemiological profile and determinant of mortality

Blunt Chest Injury: epidemiological profile and determinant of mortality

Chest trauma in the older people: epidemiological profile and treatment outcome

Breaking point? An analysis of fatal stab wounds to the torso in Ireland between 2011 and 2018, examining the extent of rib fractures

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