The profile of penetrating chest injuries in the South African private sector

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree Of Master of Science in Medicine in Emergency Medicine. Johannesburg, 2016Background Trauma is the second most common cause of death in South Africa and has been found to be the leading cause of death in young adults. Chest injury has been of interest for many years due to the evolving nature of presentations, potential for rapid deterioration, need for aggressive resuscitation and high mortality rate. Methods Data was retrospectively collected from the Netcare Trauma Bank server for the period 01 October 2006 to 01 October 2011 for all patients who presented with penetrating chest trauma. The demographic profile and presenting factors including Injury Scores were analysed. The burden of disease attributable to penetrating chest injury was then evaluated. Main Results A total of 455 patients who met the inclusion criteria were analysed. There was a male to female predominance of 7.5:1 with an average age of 35 years. The majority of patients presented over the weekend and the leading mechanism was gunshot wounds (higher ISS and NISS). Haemopneumothoraces accounted for the majority of injury pathology and an associated abdominal injury was the predominant extra thoracic injury. There were no statistically significant relationships between demographic or presenting factors and the severity of injury. A significant number of ED procedures and a considerable length of hospital stay contributed to the overall burden of disease. Conclusion Penetrating chest injuries is a significant contributor to the burden of injury and disease in South Africa.MT201