Predictors of Mortality in Patients with Isolated Chest Trauma

Document Type : Original Article

Authors

1 Department of Anesthesia, Intensive Care and Pain Medicine, Damietta Faculty of Medicine, Al-Azhar University, Egypt

2 Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Al-Azhar University, Egypt

3 Department of Cardiothoracic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt

4 Department of Anesthesia, Intensive Care and Pain Medicine, Faculty of Medicine, Al-Azhar University, Egypt

5 Pulmonologist and Intensivist at Armed Forces Hospital, Jazan, KSA

10.21608/ijma.2021.65562.1274

Abstract

Background: Chest trauma remained an important type of trauma that carries the risk of morbidity and mortality. The Modified Early Warning Score [MEWS] is a unique score as it is a physiological and simple score which permits improvement in the patient management.
The aim of the work: To assess frequency, risk factors of mortality and examine MEWS as a predictor of mortality in patients with isolated chest trauma.
Patients and Methods: Prospective analysis of 157 patients presented to emergency department, with isolated chest trauma. Demographic data, MEWS, trauma characteristics, and laboratory data were recorded on admission. The patients received standard management and were followed up until discharge or death. 
Results: Age of patients ranged from 4 to 79 years. Male constituted 79.6%. About 29% admitted with penetrating chest trauma. About 98% and 82% presented within 24 hours and had unilateral chest trauma. MEWS of them ranged from 0 to 12. There is a significant relationship between mortality and hemoglobin levels, length of hospital stay and MEWS. There is a non-significant relationship between mortality and gender, type of trauma or duration of admission. Unilateral trauma indefinitely protects against mortality. MEWS [≥7] and length of hospital stay [≥4 days] increase mortality risk by 127.3 and 4.7 folds respectively. The cutoff of MEWS for prediction of mortality was ≥ 6.5, with sensitivity of 100%, specificity of 84.9%, [p <0.001].
Conclusion: High on-admission MEWS ≥7, late presentation after 24 hour and bilateral injury were risk factors of mortality in isolated chest trauma.

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