Thoracic trauma: a descriptive review of 4168 consecutive cases in East China

Thoracic trauma in China was scarcely reported. This study aimed to summarize the clinical profiles and to analyze the management approaches of patients with traumatic thoracic injury. Data for consecutive patients with thoracic trauma from January 2003 to January 2018 were retrospectively collected and analyzed. Patients' profiles and clinical outcomes were compared between those patients treated with a dedicated thoracic trauma team and those without. The study included 4168 patients with mean age of 49.0 years, of whom 82.1% were male. Traffic accident accounted for 42.7% of the injuries. Most of the patients (66.8%) had rib fractures. Associated injuries were present in 48.3% of the patients; of them 86.0% were extremity fractures. Majority of the patients were managed without surgical procedures other than tube thoracostomy (33.2%). ICU service was needed in 12.0% of the patients. Patients treated with thoracic trauma team were older (53.59 +/- 16.8 year vs 45.1 +/- 18.0 year, P<.001), less male (78.3% vs 85.2%, P<.001), with higher injury severity scores (17.5 +/- 10.1 vs 13.7 +/- 8.2, P<.001), required more ventilator support (48.3% vs 25.3%, P<.001) and underwent more tube thoracostomy and other surgeries (43.8% vs 24.2%, and 34.4% vs 14.1%, respectively, all P<.001), yet with a shorter hospital stay (11.7 +/- 9.0 days vs 12.7 +/- 8.8 days, P<.001), and numerically lower ICU usage and mortality when compared to those without. Thoracic trauma in China usually affects mid-age males. Traffic accident is the top one etiology. The most common type of thoracic injuries is rib fracture. Associated injuries occur frequently. Nonoperative treatment and tube thoracostomy are effective for majority of the patients. A multidisciplinary approach with a dedicated thoracic trauma team could improve the treatment for these patients.