Predictors of Mortality among Patients with Flail Chest Following Thoracic Trauma

Abstract

Background: Flail chest is a severe form of thoracic trauma associated with significant morbidity and mortality. Early identification of factors associated with adverse outcomes is essential for improving patient management and survival.

Objective: This study aimed to identify predictors of mortality in patients with flail chest following thoracic trauma.

Methodology: This cross-sectional study was conducted in the Department of Thoracic Surgery at National Institute of Diseases of the Chest and Hospital (NIDCH), Dhaka, Bangladesh from January 2010 to December 2010. A total of 60 patients with flail chest were enrolled consecutively. Patients were categorized into Group I (central flail chest, n=22) and Group II (other types of flail chest, n=38).

Results: The mean age was 38.3±14.4 years in Group I and 41.4±18.2 years in Group II (p=0.471). Haemopneumothorax was the most common associated injury, occurring in 77.3% of Group I and 68.4% of Group II patients. Lung contusion and surgical emphysema were more frequent in Group I (59.1% each) than in Group II (23.7% each). Critical injury severity was observed in 81.8% of Group I and 63.2% of Group II patients. Pneumonia developed in 40.9% and 27.0% of patients, while acute respiratory distress syndrome occurred in 18.2% and 2.7% of patients in Groups I and II, respectively. Mortality was higher in Group I than in Group II (22.7% vs. 2.7%).

Conclusion: Higher injury severity, associated thoracic injuries and respiratory complications were associated with increased mortality in patients with flail chest following thoracic trauma.

Journal of National Institute of Neurosciences Bangladesh, July 2025;11(2):138-143