Predictors of death from chest trauma in a resource- poor community in Southwestern Nigeria

Abstract

Background: Injuries to the chest are usually associated with increased mortality as compared with injuries to other regions of the body due to significant respiratory and hemodynamic disturbances. We aimed at determining the predictors of mortality in thoracic trauma patients in lle Ife, Nigeria. Method: This retrospective study included all patients with chest trauma who presented at the Accident and Emergency Unit of The Obafemi Awolowo University Teaching Hospital, lle Ife between 2005 and 2007. Data was analyzed using Stata version 9. Results: There was a male preponderance (M: F = 3.5: 1) in the 118 patients. Death occurred in 9.3% of patients. The mean age was 37.6 ΁ 16.6 years with a median age of 35 years. About a third (38 of 118) sustained penetrating chest injuries while others had blunt chest injuries. The causative agent included motor vehicle accidents 66 (55.9%), gunshot injuries 28 (23.7%) and falls 12 (10.2%). Others occurred as a result of stab wounds to the chest in 10 patients (8.5%) and domestic assault in 2 (1.7%) cases. Age above 40 years and complications of chest trauma such as pulmonary contusions and adult respiratory distress syndrome were positive predictors of mortality using multiple logistic regression analysis (p- 0.041 and 0.001 respectively). Conclusion: Patient′s age above 40 years and the presence of pulmonary contusions are independent predictors of mortality in chest trauma in south western Nigeria.