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Published in: Journal of Cardiothoracic Surgery 1/2013

Open Access 01-12-2013 | Research article

Factors affecting mortality of hospitalized chest trauma patients in United Arab Emirates

Authors: Essa M AlEassa, Mariam J Al-Marashda, Amgad Elsherif, Hani O Eid, Fikri M Abu-Zidan

Published in: Journal of Cardiothoracic Surgery | Issue 1/2013

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Abstract

Background

Predictors of mortality of chest trauma vary globally. We aimed to define factors affecting mortality of hospitalized chest trauma patients in Al-Ain City, United Arab Emirates.

Methods

The data of Al-Ain Hospital Trauma Registry were prospectively collected over a period of three years. Patients with chest trauma who were admitted for more than 24 hours in Al-Ain Hospital or who died after arrival to the hospital were included in the study. Univariate analysis was used to compare patients who died and those who survived. Gender, age, nationality, mechanism of injury, systolic blood pressure and GCS on arrival, the need for ventilatory support, presence of head injury, AIS for the chest and head, presence of injuries outside the chest, and ISS were studied. Significant factors were then entered into a backward stepwise likelihood ratio logistic regression model.

Results

474 patients having a median (range) age of 35 (1–90) years were studied. 90% were males and 18% were UAE citizens. The main mechanism of injury was road traffic collisions (66%) followed by falls (23.4%). Penetrating trauma occurred in 4 patients (0.8%). 88 patients (18.6%) were admitted to the ICU. The median (range) ISS was 5 (1–43). 173 patients (36.5%) had isolated chest injury. Overall mortality rate was 7.2%. Mortality was significantly increased by low GCS (p < 0.0001), high ISS (p = 0.025), and low systolic blood pressure on arrival (p = 0.027).

Conclusion

Chest trauma is associated with a significant mortality in Al-Ain City. This was significantly related to the severity of head injury, injury severity score, and hypotension on arrival.
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Literature
1.
go back to reference Battle CE, Hutchings H, Evans PA: Risk factors that predict mortality in patients with blunt chest wall trauma: a systematic review and meta-analysis. Injury. 2012, 43: 8-17. 10.1016/j.injury.2011.01.004.CrossRefPubMed Battle CE, Hutchings H, Evans PA: Risk factors that predict mortality in patients with blunt chest wall trauma: a systematic review and meta-analysis. Injury. 2012, 43: 8-17. 10.1016/j.injury.2011.01.004.CrossRefPubMed
2.
go back to reference Emircan S, Ozgüç H, Akköse Aydın S, Ozdemir F, Köksal O, Bulut M: Factors affecting mortality in patients with thorax trauma. Ulus Travma Acil Cerrahi Derg. 2011, 17: 329-333. 10.5505/tjtes.2011.76158.CrossRefPubMed Emircan S, Ozgüç H, Akköse Aydın S, Ozdemir F, Köksal O, Bulut M: Factors affecting mortality in patients with thorax trauma. Ulus Travma Acil Cerrahi Derg. 2011, 17: 329-333. 10.5505/tjtes.2011.76158.CrossRefPubMed
3.
go back to reference Dubinsky I, Low A: Non-life-threatening blunt chest trauma: appropriate investigation and treatment. Am J Emerg Med. 1997, 15: 240-243. 10.1016/S0735-6757(97)90004-8.CrossRefPubMed Dubinsky I, Low A: Non-life-threatening blunt chest trauma: appropriate investigation and treatment. Am J Emerg Med. 1997, 15: 240-243. 10.1016/S0735-6757(97)90004-8.CrossRefPubMed
4.
go back to reference Harrington DT, Phillips B, Machan J, Zacharias N, Velmahos GC, Rosenblatt MS, Winston E, Patterson L, Desjardins S, Winchell R, Brotman S, Churyla A, Schulz JT, Maung AA, Davis KA, Research Consortium of New England Centers for Trauma (ReCONECT): Factors associated with survival following blunt chest trauma in older patients: results from a large regional trauma cooperative. Arch Surg. 2010, 145: 432-437. 10.1001/archsurg.2010.71.CrossRefPubMed Harrington DT, Phillips B, Machan J, Zacharias N, Velmahos GC, Rosenblatt MS, Winston E, Patterson L, Desjardins S, Winchell R, Brotman S, Churyla A, Schulz JT, Maung AA, Davis KA, Research Consortium of New England Centers for Trauma (ReCONECT): Factors associated with survival following blunt chest trauma in older patients: results from a large regional trauma cooperative. Arch Surg. 2010, 145: 432-437. 10.1001/archsurg.2010.71.CrossRefPubMed
5.
go back to reference Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S: Chest injury due to blunt trauma. Eur J Cardiothorac Surg. 2003, 23: 374-378. 10.1016/s1010-7940(02)00813-8.CrossRefPubMed Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S: Chest injury due to blunt trauma. Eur J Cardiothorac Surg. 2003, 23: 374-378. 10.1016/s1010-7940(02)00813-8.CrossRefPubMed
6.
go back to reference Demirhan R, Onan B, Oz K, Halezeroglu S: Comprehensive analysis of 4205 patients with chest trauma: a 10-year experience. Interact Cardiovasc Thorac Surg. 2009, 9: 450-453. 10.1510/icvts.2009.206599.CrossRefPubMed Demirhan R, Onan B, Oz K, Halezeroglu S: Comprehensive analysis of 4205 patients with chest trauma: a 10-year experience. Interact Cardiovasc Thorac Surg. 2009, 9: 450-453. 10.1510/icvts.2009.206599.CrossRefPubMed
7.
go back to reference Lema MK, Chalya PL, Mabula JB, Mahalu W: Pattern and outcome of chest injuries at Bugando Medical Centre in northwestern Tanzania. J Cardiothorac Surg. 2011, 6: 7-10.1186/1749-8090-6-7.CrossRefPubMedPubMedCentral Lema MK, Chalya PL, Mabula JB, Mahalu W: Pattern and outcome of chest injuries at Bugando Medical Centre in northwestern Tanzania. J Cardiothorac Surg. 2011, 6: 7-10.1186/1749-8090-6-7.CrossRefPubMedPubMedCentral
8.
go back to reference Shaban S, Eid HO, Barka E, Abu-Zidan FM: Towards a national trauma registry for the United Arab Emirates. BMC Res Notes. 2010, 3: 187-10.1186/1756-0500-3-187.CrossRefPubMedPubMedCentral Shaban S, Eid HO, Barka E, Abu-Zidan FM: Towards a national trauma registry for the United Arab Emirates. BMC Res Notes. 2010, 3: 187-10.1186/1756-0500-3-187.CrossRefPubMedPubMedCentral
9.
go back to reference Shaban S, Ashour M, Bashir M, El-Ashaal Y, Branicki F, Abu-Zidan FM: The long term effects of early analysis of a trauma registry. World J Emerg Surg. 2009, 4: 42-10.1186/1749-7922-4-42.CrossRefPubMedPubMedCentral Shaban S, Ashour M, Bashir M, El-Ashaal Y, Branicki F, Abu-Zidan FM: The long term effects of early analysis of a trauma registry. World J Emerg Surg. 2009, 4: 42-10.1186/1749-7922-4-42.CrossRefPubMedPubMedCentral
10.
go back to reference Association of the Advancement of Automotive Medicine: Abbreviated Injury Scale. 1998, Barrington, IL: Association for the Advancement of Automotive Medicine Association of the Advancement of Automotive Medicine: Abbreviated Injury Scale. 1998, Barrington, IL: Association for the Advancement of Automotive Medicine
11.
go back to reference Kulshrestha P, Munshi I, Wait R: Profile of chest trauma in a level I trauma center. J Trauma. 2004, 57: 576-581. 10.1097/01.TA.0000091107.00699.C7.CrossRefPubMed Kulshrestha P, Munshi I, Wait R: Profile of chest trauma in a level I trauma center. J Trauma. 2004, 57: 576-581. 10.1097/01.TA.0000091107.00699.C7.CrossRefPubMed
14.
go back to reference Mock CN, Jurkovich GJ, nii-Amon-Kotei D, Arreola-Risa C, Maier RV: Trauma mortality patterns in three nations at different economic levels: implications for global trauma systems development. J Trauma. 1998, 44: 804-812. 10.1097/00005373-199805000-00011.CrossRefPubMed Mock CN, Jurkovich GJ, nii-Amon-Kotei D, Arreola-Risa C, Maier RV: Trauma mortality patterns in three nations at different economic levels: implications for global trauma systems development. J Trauma. 1998, 44: 804-812. 10.1097/00005373-199805000-00011.CrossRefPubMed
16.
go back to reference Abu-Zidan FM, Abbas AK, Hefny AF, Eid HO, Grivna M: Effects of seat belt usage on injury pattern and outome of vehicle occupants after road traffic collisions: prospective study. World J Surg. 2012, 36: 255-259. 10.1007/s00268-011-1386-y.CrossRefPubMed Abu-Zidan FM, Abbas AK, Hefny AF, Eid HO, Grivna M: Effects of seat belt usage on injury pattern and outome of vehicle occupants after road traffic collisions: prospective study. World J Surg. 2012, 36: 255-259. 10.1007/s00268-011-1386-y.CrossRefPubMed
17.
go back to reference Eid HO, Abu-Zidan FM: Biomechanics of road traffic collision injuries: a clinician’s perspective. Singapore Med J. 2007, 48: 693-700.PubMed Eid HO, Abu-Zidan FM: Biomechanics of road traffic collision injuries: a clinician’s perspective. Singapore Med J. 2007, 48: 693-700.PubMed
18.
go back to reference Eid HO, Barss P, Adam SH, Torab FC, Lunsjo K, Grivna M, Abu-Zidan FM: Factors affecting anatomical region of injury, severity, and mortality for road trauma in a high-income developing country: lessons for prevention. Injury. 2009, 40: 703-707. 10.1016/j.injury.2008.07.012.CrossRefPubMed Eid HO, Barss P, Adam SH, Torab FC, Lunsjo K, Grivna M, Abu-Zidan FM: Factors affecting anatomical region of injury, severity, and mortality for road trauma in a high-income developing country: lessons for prevention. Injury. 2009, 40: 703-707. 10.1016/j.injury.2008.07.012.CrossRefPubMed
19.
go back to reference Flagel BT, Luchette FA, Reed RL, Esposito TJ, Davis KA, Santaniello JM, Gamelli RL: Half-a-dozen ribs: the breakpoint for mortality. Surgery. 2005, 138: 717-723. 10.1016/j.surg.2005.07.022.CrossRefPubMed Flagel BT, Luchette FA, Reed RL, Esposito TJ, Davis KA, Santaniello JM, Gamelli RL: Half-a-dozen ribs: the breakpoint for mortality. Surgery. 2005, 138: 717-723. 10.1016/j.surg.2005.07.022.CrossRefPubMed
20.
go back to reference Lien YC, Chen CH, Lin HC: Risk factors for 24-hour mortality after traumatic rib fractures owing to motor vehicle accidents: a nationwide population-based study. Ann Thorac Surg. 2009, 88: 1124-1130. 10.1016/j.athoracsur.2009.06.002.CrossRefPubMed Lien YC, Chen CH, Lin HC: Risk factors for 24-hour mortality after traumatic rib fractures owing to motor vehicle accidents: a nationwide population-based study. Ann Thorac Surg. 2009, 88: 1124-1130. 10.1016/j.athoracsur.2009.06.002.CrossRefPubMed
21.
go back to reference Peduzzi P, Concato J, Feinstein AR, Holford TR: Importance of events per independent variable in proportional hazards regression analysis. J Clin Epidemiol. 1995, 48: 1503-1510. 10.1016/0895-4356(95)00048-8.CrossRefPubMed Peduzzi P, Concato J, Feinstein AR, Holford TR: Importance of events per independent variable in proportional hazards regression analysis. J Clin Epidemiol. 1995, 48: 1503-1510. 10.1016/0895-4356(95)00048-8.CrossRefPubMed
22.
go back to reference Vittinghoff E, McCulloch CE: Relaxing the rule of ten events per variable in logistic and cox regression. Am J Epidemiol. 2007, 165: 710-718. 10.1093/aje/kwk052.CrossRefPubMed Vittinghoff E, McCulloch CE: Relaxing the rule of ten events per variable in logistic and cox regression. Am J Epidemiol. 2007, 165: 710-718. 10.1093/aje/kwk052.CrossRefPubMed
Metadata
Title
Factors affecting mortality of hospitalized chest trauma patients in United Arab Emirates
Authors
Essa M AlEassa
Mariam J Al-Marashda
Amgad Elsherif
Hani O Eid
Fikri M Abu-Zidan
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2013
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/1749-8090-8-57

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