Pattern and outcome of penetrating chest injuries at the Emergency Management Center in Erbil City
Background and objective: Trauma to the chest is a life-threatening condition because the chest contains many vital organs such as the heart, multiple blood vessels, and lungs. This study aimed to identify the pattern and outcome of the war-related penetrating chest injuries at the Emergency Management Center, Erbil, during the Islamic State in Iraq and Syria conflict.
Methods: This retrospective study involved 154 chest injured victims at the Emergency Management Centre in Erbil City. Data were collected from the Statistics Department of this hospital from June 2014 to July 2017.
Results: The mean (SD) age of the victims was 25.75 ± 11.567 years. The majority of the cases were young (61%), male (85.1%), Kurds (72.1%), and injured outside Erbil governorate (40.9%). The leading cause of injury was bullet injury (74.7 %). Provision of the first aid before admission was high (87%). Most victims did not have any other injuries (66.9%). Surgical operations were performed to the majority of victims (93.5%). Most of them did not develop any complications (78.6%), with only 21.4% of the cases had some complications. The development of the complications was significantly associated with the presence of other injuries (68.6% vs. 83.5%, P = 0.034).
Conclusion: During the Islamic State in Iraq and Syria related war in Iraq, chest injury by gunshot had increased. The Emergency Management Center provides a suitable medical service that helped in reducing complications and deaths. The development of complications was significantly associated only with the presence of multiple injuries.
Shah JV, Solanki MI. Analytic Study of Chest Injury. IJSS J Surg 2015; 1(1):5–9.
Dodia H, Sansiya K. A Study of Penetrating Thoracic and Abdominal Injuries. J Dent Med Sci 2015; 14(8):64–95.
Kumar BA, Chakravarthy GR, Bharath A. Blunt Trauma Chest: A Study on Clinical Pattern. J Dent Med Sci 2017; 16(3):1–7.
Lugo VW, Gastelum AS, Armas AH, Garnica FG, Gómez MG. Chest trauma: An overview. J Anaesth Crit Care Open Access 2015; 3(1):00082.
DeBakey ME. Emergency War Surgery. United States of America. 3rd ed. U.S. revision; Library of Congress Cataloging-in-Publication; 2004. P. 224.
Mohammadzadeh M. Hosseinpour M, Mirzadeh AS, Jazayeri H, Arani MG. Chest Injury Evaluation and Management Two Major Trauma Centers of Isfahan Province, IR Ira. Arch Trauma Res 2012; 1(2):54–7.
Aghdas SA, Bazargan HS, Shabanineja H, Gor HA. Injury epidemiology in Iran: a systematic review. J Inj Violence Res 2017; 9(1):27–40.
Demirhana R, Onana B, Oza K, Halezeroglu S. Comprehensive analysis of 4205 patients with chest trauma: a 10-year experience. Interactive Cardiovasc Thorac Surg 2009; 9:450–3.
Karaca MA, Kartal ND, Erbil B, Öztürk E, Kunt MM, Şahin TT, et al. Evaluation of gunshot wounds in the emergency department. Ulus Travma Acil Cerrahi Derg 2015; 21(4):248–55.
Aldahmashi MN. Patterns of Chest Injuries among Yemeni patients: Aretrospective analysis. Yemeni J Med Sci 2015; 9:22–30.
Atri M, Singh G, Kohli A.Chest trauma in Jammu region an institutional study. Thorac Cardiovasc Surg 2006; 22:219–22.
Dodge I, Coskun A, Ozbay S, Bayram M, Atli B. Management of thoracic trauma in emergency service: Analysis of 1139 cases. Pak J Med Sci 2013; 29(1):58–63.
Hemmati H, Leili EK, Amiri ZM, Darzi AA, Kiakalayeh AD, Moghaddam AD, et al. Evaluation of chest and abdominal injuries in trauma patients hospitalized in the surgery ward of Poursina Teaching Hospital, Guilan, Iran. Arch Trauma Res 2013; 1(4):161–5.
Mohta M, Kumar P, Mohta A, Bhardwaj R, Tyagi A, Sethi AK. Experiences with chest trauma: Where do we stand today? Indian J Crit Care Med 2006; 10(1):25–8.
Khan IA, Ghaffar S, Asif S, Rehman Z, Asad S, Ahmed E, et al. Management of thoracic trauma: Experience at Ayub Teaching Hospital, Abbottabad. J Ayub Med Coll 2009; 21(1):152– 4.
Tsai YM, Lin KH, Huang TW, Chen CY, Hong ZJ, Hsu SD. Outcomes of patients with blunt chest trauma encountered at emergency department and possible risk factors affecting mortality. J Med Sci 2017; 37(3):97–101.
Ali N, Gali BM. Pattern and management of chest injuries in Maiduguri, Nigeria. Ann Afr Med 2004; 3(4):181–4.
Mohan PV, Mohan R. Management of warfare chest injuries. Med J Armed Forces India 2011; 66(4):329–32.
Saeed AY, Hamza AA, Ismail OM. Pattern and management outcome of chest injuries in Omdurman Teaching Hospital Sudan. Global J Med Res 2015; 15:1.
Sheffy N, Chemsian RV, Grabinsky A. Anaesthesia considerations in penetrating trauma. Br J Anaesth 2014; 113(2):276–85.
Chrysou K, Halat G, Hoksch B, Schmid RA, Kocher GJ. Lessons from a large trauma center: impact of blunt chest trauma in polytrauma patients still a relevant problem? Scand J Trauma Resusc Emerg Med 2017; 25(1):42.
Pramod T, Shashirekha CA, Chandan KR, Harsha R. Role of conservative management of traumatic chest injuries: A retrospective study and review of literature. Int J Sci Stud 2015; 3(8):147–50.
Freixinet J, Beltrán J, Rodríguez PM, Juliá G, Hussein M, Gil R, et al. Indicators of severity in chest trauma. Arch Bronconeumol 2008; 44(5):257–62.
Elmali M, Baydın A, Nural MS, Arslan B, Ceyhan M, Gürmen N. Lung parenchymal injury and its frequency in blunt thoracic trauma: the diagnostic value of chest radiography and thoracic CT. DiagnInterv Radiol 2007; 13:179–82.
Bouzat P, Raux M, David JS, Tazarourte K, Galinski M, Desmettre T.Chest trauma: First 48 hours management. Anaesth Crit Care Pain Med 2017; 36:135–45.
Peleg K, Daniel LA, Michael M, Shapira SC, Israel Trauma Group. Patterns of injury in hospitalized terrorist victims. Am J Emerg Med 2003; 21(4):258–62.
Kumar A, Verma AK, Srivastava AK. Penetrating chest injuries: A medicolegalanalysis. J Indian Acad Forensic Med 2007; 32(1):34–6.
Moodley P. The profile of penetrating chest injuries in the South African private sector; 2016. (Accessed Oct 18, 2018, at: http://wiredspace.wits.ac.za/bitstream/handle/10539/22576/MMed%20Final%20Report.pdf?sequence=1&isAllowed=y).
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