Evaluation of risk factors for prognosticating blunt chest trauma.

Introduction: Blunt chest trauma contributes to a significant number of trauma admissions globally and is the leading cause of morbidity and mortality. Although numerous scoring systems and risk factors for prognosticating blunt chest trauma have already been developed, we are still lacking a gold standard in this field. Aim: This study was conducted to reassess the significance of available scoring systems and other indicators of severity in prognosticating blunt chest trauma. Materials and methods: This prospective observational study analyzed 50 patients over 12 years of age who suffered a blunt chest trauma and required hospitalization in the period between November 2016 and March 2018. the following nine risk factors were assessed: age of the patient, time of presentation after injury, number of ribs fractured, presence of bilateral thoracic trauma, evidence of pulmonary contusion, associated extra-thoracic injuries, the need for mechanical ventilation, as well as the results of Revised Trauma Score (RTS) and Modified Early Warning Sign Score (MEWS). the severity of blunt thoracic trauma was divided into three categories - SIRS, ARDS and death. Data was analyzed with the use of statistical software package SPSS v22.0. Results: The age of 50 patients included in our study ranged from 15 to 76 years old, while the median value was 35.5 years old. Statistically significant correlation was observed between the SIRS occurrence rate and multiple rib fractures (p-value - 0.049), associated extra-thoracic injuries (p-value - 0.016) and higher MEWS score (p-value - 0.025). Statistically significant correlation was also observed between the rate of ARDS occurrence and all risk factors excluding age. Mortality was higher among patients with delayed presentation to hospital (p-value < 0.001), multiple rib fractures (p-value - 0.001), presence of bilateral thoracic injury (p-value < 0.001), associated extra-thoracic injuries (p-value - 0.004), as well as in patients who required ventilatory support (p-value < 0.001) or demonstrated low RTS (p-value - 0.006) and high MEWS (p-value - 0.005) on admission. This correlation was found to be statistically significant. Conclusion: High MEWS, associated extra-thoracic injuries and multiple rib fractures are good predictors of poor clinical outcome in terms of SIRS, ARDS and death. Aggressive treatment protocols should be established in order to achieve better outcomes in these patients. [ABSTRACT FROM AUTHOR]