Outcome Analysis of Tracheobronchial Injuries at a Large Service Hospital
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 2
Abstract
Background: Tracheobronchial injuries, although uncommon, are potentially fatal injuries consequent to both blunt and penetrating neck and chest trauma. Majority of the patients die at the scene before reaching definitive care centers. Moreover, the diagnosis and treatment of these unusual injuries is often missed or delayed, resulting in a significant number of preventable deaths or marked morbidity. Methodology: All patients with tracheobronchialinjuries presenting at a large service hospital in New Delhi between January 2014 and December 2018 were studied prospectively to determine the current pattern, presentation, and associated injuries along with modalities for diagnosis, treatment, and outcome of these injuries. Only those patients with tracheobronchial injuries who were alive at presentation and consented to be a part of the study were included in the study. Results were analyzed with the currently available literature on the subject. Results: A total of 52 patients were enrolled for the study during the above-mentioned duration. Injuries were consequent to both blunt and penetrating trauma in almost equal proportions. The most common presentation was found to be surgical emphysema in 21 patients. The injurywas detected within 3 cm of the carina in 65% of the patients with blunt tracheal trauma, whereas cervical trachea was injured in majority (81%) of the penetrating injuries of the neck. Theproximity of the injury to the carina had no detectable effecton mortality. Overall, mortality from tracheobronchial injury was 17%, mainly consequent to multiple neck or chest traumas or other significant associated injuries. Conclusion: To the best of our knowledge, this study represents one of the most comprehensive cohorts of patients with tracheobronchial injuries evaluated and managed at a service hospital till date. These injuries are potentially life threatening and warrant quick assessment and management. The associated morbidity and mortality continue to be significant enough to highlight the importance of high index of suspicion, early detection, and appropriate management of these serious and often missed injuries.
Authors and Affiliations
Pawan Sharma, Abhishek Sharma, Zenith Mohanty, K M Mehdi, Usha Kumari, Sanya Chikara
Keywords
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