THE BURDEN OF ISOLATED THORACIC TRAUMA IN INDIA: A 7-YEAR RETROSPECTIVE ANALYSIS OF 794 PATIENTS

Abstract

 Thoracic trauma accounts for 15–25% of severe trauma admissions globally, with high mortality rates in resource-limited settings. Despite advances in imaging and interventions, isolated thoracic injuries remain understudied, particularly in low- and middle-income countries.
Objective: This study analyses the epidemiology, management strategies, and outcomes of isolated thoracic trauma at a tertiary care centre in India.

Methods: A retrospective cohort analysis was conducted on 794 patients with isolated chest trauma (blunt or penetrating) admitted between July 2018 and June 2025. Data included demographics, injury mechanisms, interventions (e.g., tube thoracostomy, thoracotomy), pain management, and complications. Statistical analysis employed descriptive and inferential methods (t-tests, chi-square).
Results: Of 1,905 trauma admissions, 41.7% (n=794) had isolated thoracic injuries, predominantly blunt trauma (91.7%). Road traffic accidents (52%) and falls (16.2%) were the leading causes. Only 6% presented within the "golden hour." Common injuries included multiple rib fractures (91%), pneumothorax (39.1%), and haemothorax (60.9%). Intercostal drainage was performed in 84%, while surgical rib fixation was notably absent despite flail chest in 7.4% of cases. Mortality was 4.6%, associated with age >50 years, delayed admission, and mechanical ventilation.

Conclusion: Isolated thoracic trauma carries significant morbidity, with outcomes influenced by timely intervention and multimodal analgesia. Underutilization of surgical rib fixation and regional anaesthesia highlights gaps in adherence to global guidelines. Standardized protocols incorporating early stabilization and advanced pain management may improve outcomes in resource-limited settings.