Abstract
Background: Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. Associated chest trauma is frequently encountered in patients with TBI and may adversely affect neurological recovery by causing hypoxia, respiratory complications, and prolonged intensive care requirements.
Objective: To evaluate the impact of associated chest trauma on clinical outcomes, complications, mortality, and hospital course in patients with traumatic brain injury.
Materials and Methods: This prospective observational study was conducted in the Department of General Surgery, Gandhi Medical College and Hamidia Hospital, Bhopal, India. A total of 196 adult patients with traumatic brain injury were enrolled. Patients were categorized into isolated TBI (n=65) and TBI with associated chest trauma (n=131) groups. Clinical characteristics, injury severity, ventilator requirement, interventions, complications, neurological outcomes, mortality, ICU stay, and hospital stay were analyzed. Statistical analysis was performed using SPSS software, and a p-value <0.05 was considered statistically significant.
Results: Among 196 patients, 66.8% had associated chest trauma. The mean age was 46.79 ± 17.66 years, and males constituted 75% of the study population. Baseline demographic characteristics, Glasgow Coma Scale score, Injury Severity Score, and CT head severity were comparable between groups. Postoperative complications and ARDS occurrence did not differ significantly. However, significant differences were observed regarding ventilator requirement, neurosurgical intervention, secondary neurologic insult, mortality, and ICU stay (p<0.05). Patients with associated chest trauma had a significantly longer ICU stay (6.92 ± 3.42 vs. 5.48 ± 3.36 days; p=0.006).
Conclusion: Associated chest trauma is common among patients with traumatic brain injury and contributes to increased critical care utilization and adverse clinical outcomes. Early recognition and aggressive management of thoracic injuries may improve overall prognosis in patients with TBI.
Keywords: Traumatic brain injury; Chest trauma; Neurologic outcome; Mortality; ICU stay; Thoracic injury.