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Retrospective cohort analysis of chest injury characteristics and concurrent injuries in patients admitted to hospital in the Wenchuan and Lushan earthquakes in Sichuan, China.

Zheng X, Hu Y, Yuan Y, Zhao YF - PLoS ONE (2014)

Bottom Line: The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types.The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity.Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake-related chest injuries.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.

ABSTRACT

Background: The aim of this study was to compare retrospectively the characteristics of chest injuries and frequencies of other, concurrent injuries in patients after earthquakes of different seismic intensity.

Methods: We compared the cause, type, and body location of chest injuries as well as the frequencies of other, concurrent injuries in patients admitted to our hospital after the Wenchuan and Lushan earthquakes in Sichuan, China. We explored possible relationships between seismic intensity and the causes and types of injuries, and we assessed the ability of the Injury Severity Score, New Injury Severity Score, and Chest Injury Index to predict respiratory failure in chest injury patients.

Results: The incidence of chest injuries was 9.9% in the stronger Wenchuan earthquake and 22.2% in the less intensive Lushan earthquake. The most frequent cause of chest injuries in both earthquakes was being accidentally struck. Injuries due to falls were less prevalent in the stronger Wenchuan earthquake, while injuries due to burial were more prevalent. The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types. Spinal and head injuries concurrent with chest injuries were more prevalent in the less violent Lushan earthquake. All three trauma scoring systems showed poor ability to predict respiratory failure in patients with earthquake-related chest injuries.

Conclusions: Previous studies may have underestimated the incidence of chest injury in violent earthquakes. The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity. Earthquake severity and interval between rescue and treatment may influence the prevalence and types of injuries that co-occur with the chest injury. Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake-related chest injuries.

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Receiver operating characteristic (ROC) curves of different trauma scoring systems for predicting respiratory failure in patients admitted to our hospital in the Lushan earthquake.The solid line indicates the ROC curve for the Injury Severity Score (ISS); the dashed line, the curve for the New Injury Severity Score (NISS); and the dotted line, the curve for the Chest Injury Index (CII) [4].
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pone-0097354-g001: Receiver operating characteristic (ROC) curves of different trauma scoring systems for predicting respiratory failure in patients admitted to our hospital in the Lushan earthquake.The solid line indicates the ROC curve for the Injury Severity Score (ISS); the dashed line, the curve for the New Injury Severity Score (NISS); and the dotted line, the curve for the Chest Injury Index (CII) [4].

Mentions: In the Wenchuan earthquake, 38 inpatients with chest injuries (20.7%) suffered from respiratory failure [4]. In the Lushan disaster, 18 of the 72 inpatients with chest injuries (25.0%) developed respiratory failure. Building on our previous work assessing the ability of the ISS, NISS and CII scales to predict respiratory failure in chest injury patients in the Wenchuan earthquake, we performed the same analysis on Lushan patients. We calculated the area under ROC curves and estimated 95% confidence intervals (95%CI) for all scales (Figure 1 and Table 6). Although NISS was significantly more accurate than the two other scales in our analysis of Wenchuan chest injury patients [4], all three scales performed similarly poorly for Lushan chest injury patients.


Retrospective cohort analysis of chest injury characteristics and concurrent injuries in patients admitted to hospital in the Wenchuan and Lushan earthquakes in Sichuan, China.

Zheng X, Hu Y, Yuan Y, Zhao YF - PLoS ONE (2014)

Receiver operating characteristic (ROC) curves of different trauma scoring systems for predicting respiratory failure in patients admitted to our hospital in the Lushan earthquake.The solid line indicates the ROC curve for the Injury Severity Score (ISS); the dashed line, the curve for the New Injury Severity Score (NISS); and the dotted line, the curve for the Chest Injury Index (CII) [4].
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4016322&req=5

pone-0097354-g001: Receiver operating characteristic (ROC) curves of different trauma scoring systems for predicting respiratory failure in patients admitted to our hospital in the Lushan earthquake.The solid line indicates the ROC curve for the Injury Severity Score (ISS); the dashed line, the curve for the New Injury Severity Score (NISS); and the dotted line, the curve for the Chest Injury Index (CII) [4].
Mentions: In the Wenchuan earthquake, 38 inpatients with chest injuries (20.7%) suffered from respiratory failure [4]. In the Lushan disaster, 18 of the 72 inpatients with chest injuries (25.0%) developed respiratory failure. Building on our previous work assessing the ability of the ISS, NISS and CII scales to predict respiratory failure in chest injury patients in the Wenchuan earthquake, we performed the same analysis on Lushan patients. We calculated the area under ROC curves and estimated 95% confidence intervals (95%CI) for all scales (Figure 1 and Table 6). Although NISS was significantly more accurate than the two other scales in our analysis of Wenchuan chest injury patients [4], all three scales performed similarly poorly for Lushan chest injury patients.

Bottom Line: The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types.The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity.Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake-related chest injuries.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.

ABSTRACT

Background: The aim of this study was to compare retrospectively the characteristics of chest injuries and frequencies of other, concurrent injuries in patients after earthquakes of different seismic intensity.

Methods: We compared the cause, type, and body location of chest injuries as well as the frequencies of other, concurrent injuries in patients admitted to our hospital after the Wenchuan and Lushan earthquakes in Sichuan, China. We explored possible relationships between seismic intensity and the causes and types of injuries, and we assessed the ability of the Injury Severity Score, New Injury Severity Score, and Chest Injury Index to predict respiratory failure in chest injury patients.

Results: The incidence of chest injuries was 9.9% in the stronger Wenchuan earthquake and 22.2% in the less intensive Lushan earthquake. The most frequent cause of chest injuries in both earthquakes was being accidentally struck. Injuries due to falls were less prevalent in the stronger Wenchuan earthquake, while injuries due to burial were more prevalent. The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types. Spinal and head injuries concurrent with chest injuries were more prevalent in the less violent Lushan earthquake. All three trauma scoring systems showed poor ability to predict respiratory failure in patients with earthquake-related chest injuries.

Conclusions: Previous studies may have underestimated the incidence of chest injury in violent earthquakes. The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity. Earthquake severity and interval between rescue and treatment may influence the prevalence and types of injuries that co-occur with the chest injury. Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake-related chest injuries.

Show MeSH
Related in: MedlinePlus