Publication:

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

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.