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Original Research



Traumatic pneumothorax in a secondary emergency care hospital

Atsushi Sano, Takehiro Tsuchiya.




Abstract
Cited by 1 Articles

Background: While patients with severe chest injuries are generally treated in tertiary emergency care hospitals, those with mild-to-moderate chest injuries are often treated in primary or secondary emergency care facilities. Even mild-to-moderate chest injuries can result in traumatic pneumothorax, and should be treated immediately. Herein, we analyzed patients with traumatic pneumothorax at our hospital, a secondary emergency care facility.
Methods: Our institution deals mainly with mild-to-moderate trauma. We retrospectively analyzed the medical records and images of patients identified from our institution’s chest injury database.
Results: Between April 2008 and December 2013, 934 patients with chest injuries were referred to our hospital. Of these, 45 were diagnosed with traumatic pneumothorax. Patient ages ranged from 24 to 84 years (average 61.3 years). Traffic accidents were the most frequent cause of injury, followed by falling on a flat surface and falling from a height. Rib fractures were identified in 40 of 45 patients. The incidence of pneumothorax correlated with the number of rib fractures (r = 0.889, Pearson’s correlation coefficient). Three of 29 pneumothorax patients who presented on the day of injury were diagnosed with pneumothorax on a later day. By contrast, all 16 pneumothorax patients who presented one or more days after the injury were diagnosed with pneumothorax on the day of consultation. Chest drainage was performed in 25 patients. No mortality or severe morbidity was observed.
Conclusion: Mild-to-moderate chest injuries treated at a secondary emergency care hospital are rarely life-threatening, but it is important to remember that traumatic pneumothorax is still possible and can occur days after the initial injury.

Key words: traumatic pneumothorax, rib fracture, chest injury, drainage, secondary emergency care hospital






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