Analysis on short-term outcomes of patients with thoracic trauma at dr. Zainoel Abidin General Hospital in Banda Aceh

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Zainoel Abidin General Hospital in...", "datePublished": "2022-04-20T10:49:15", "dateModified": "2024-07-03T10:47:50", "author": [ { "@type": "Person", "name": "Yopie Afriandi Habibie" }, { "@type": "Person", "name": "Widya Anisa" }, { "@type": "Person", "name": "Nurkhalis Nurkhalis" }, { "@type": "Person", "name": "Azharuddin Azharuddin" }, { "@type": "Person", "name": "Muhammad Ridwan" } ], "publisher": { "@type": "Organization", "name": "F1000Research", "logo": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 480, "width": 60 } }, "image": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 1200, "width": 150 }, "description": " Background Thoracic trauma is defined as a trauma that hits the chest wall directly or indirectly, either as a result of blunt or penetrating trauma. Thoracic trauma can occur in any age or genders, and become a life-threatening if the treatment isn’t immediate and appropriate. Methods This research was an observational study with a cohort retrospective design using secondary data in the form of thoracic trauma patients at The Zainoel Abidin General Hospital, Banda Aceh, Indonesia in the period January 2019-December 2020. The statistical analysis used were chi square for bivariate and multivariate analysis, spesifically logistic regression analysis was conducted to know which risk factor influences the most. Result There were 141 medical records used in this study, thoracic trauma was more common in men compared to women. The age group of 46-55 is the age group with the highest percentage of thoracic trauma patients, road traffic are the leading cause of thoracic trauma where the most common diagnosis is rib fractures. Significant factors that associated with the short outcome of thoracic trauma are thoracic trauma diagnosis (p=0,00), management of thoracic trauma (p=0,00), ventilator (p=0,04), duration of ventilator (p=0.01), sepsis (p=0,00), qSOFA score (p=0,00) and injury severity score (p=0,00). Conclusions Vehicle accidents contributed to a considerable number of traumatic chest injuries in this study. Diagnosis, management of trauma, days of ventilation, qSOFA score, injury severity score, and development of sepsis were associated with the short-term outcome among thoracic trauma patients. Injury severity score seems to be the most influential variable in this study, the lower the better it is. Road safety intervention is urgently needed to control the underlying problems in this study. 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F1000Research 2024, 11 :441 ( https://doi.org/10.12688/f1000research.110976.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Analysis on short-term outcomes of patients with thoracic trauma at dr. Zainoel Abidin General Hospital in Banda Aceh [version 2; peer review: 1 approved with reservations] Yopie Afriandi Habibie https://orcid.org/0000-0003-1007-3097 1 , Widya Anisa 2 , Nurkhalis Nurkhalis 3 , Azharuddin Azharuddin 4 , Muhammad Ridwan https://orcid.org/0000-0002-1017-9636 5 Yopie Afriandi Habibie https://orcid.org/0000-0003-1007-3097 1 , Widya Anisa 2 , [...] Nurkhalis Nurkhalis 3 , Azharuddin Azharuddin 4 , Muhammad Ridwan https://orcid.org/0000-0002-1017-9636 5 PUBLISHED 03 Jul 2024 Author details Author details 1 Division of Thoracic Cardiac and Vascular Surgery, Department of Surgery, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia 2 Scholar, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia 3 Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia 4 Division of Orthopaedic and Traumatology, Department of Surgery, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia 5 Division of Cardiac Rehabilitation, Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia Yopie Afriandi Habibie Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Widya Anisa Roles: Data Curation, Formal Analysis, Methodology, Project Administration, Software, Validation, Writing – Original Draft Preparation Nurkhalis Nurkhalis Roles: Data Curation, Formal Analysis, Investigation, Methodology Azharuddin Azharuddin Roles: Data Curation, Formal Analysis, Methodology, Supervision, Validation Muhammad Ridwan Roles: Data Curation, Formal Analysis, Methodology, Supervision, Validation OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background Thoracic trauma is defined as a trauma that hits the chest wall directly or indirectly, either as a result of blunt or penetrating trauma. Thoracic trauma can occur in any age or genders, and become a life-threatening if the treatment isn’t immediate and appropriate. Methods This research was an observational study with a cohort retrospective design using secondary data in the form of thoracic trauma patients at The Zainoel Abidin General Hospital, Banda Aceh, Indonesia in the period January 2019-December 2020. The statistical analysis used were chi square for bivariate and multivariate analysis, spesifically logistic regression analysis was conducted to know which risk factor influences the most. Result There were 141 medical records used in this study, thoracic trauma was more common in men compared to women. The age group of 46-55 is the age group with the highest percentage of thoracic trauma patients, road traffic are the leading cause of thoracic trauma where the most common diagnosis is rib fractures. Significant factors that associated with the short outcome of thoracic trauma are thoracic trauma diagnosis (p=0,00), management of thoracic trauma (p=0,00), ventilator (p=0,04), duration of ventilator (p=0.01), sepsis (p=0,00), qSOFA score (p=0,00) and injury severity score (p=0,00). Conclusions Vehicle accidents contributed to a considerable number of traumatic chest injuries in this study. Diagnosis, management of trauma, days of ventilation, qSOFA score, injury severity score, and development of sepsis were associated with the short-term outcome among thoracic trauma patients. Injury severity score seems to be the most influential variable in this study, the lower the better it is. Road safety intervention is urgently needed to control the underlying problems in this study. READ ALL READ LESS Keywords thoracic trauma, short-term outcome, injury severity score, management of chest trauma Corresponding Author(s) Yopie Afriandi Habibie ( [email protected] ) Close Corresponding author: Yopie Afriandi Habibie Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2024 Habibie YA et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Habibie YA, Anisa W, Nurkhalis N et al. Analysis on short-term outcomes of patients with thoracic trauma at dr. Zainoel Abidin General Hospital in Banda Aceh [version 2; peer review: 1 approved with reservations] . F1000Research 2024, 11 :441 ( https://doi.org/10.12688/f1000research.110976.2 ) First published: 20 Apr 2022, 11 :441 ( https://doi.org/10.12688/f1000research.110976.1 ) Latest published: 03 Jul 2024, 11 :441 ( https://doi.org/10.12688/f1000research.110976.2 ) Revised Amendments from Version 1 The second version of the manuscript replaces the first version after revisions were made. Changes have been made to the abstract's results. Spelling and punctuation errors have been corrected in the figure captions in introduction. We have added more details to the methodology about the definition of Injury Severity Score (ISS) and quick Sequential Organ Failure Assessment (qSOFA). Additionally, we have made changes to the sentences in the discussion section. Two citations regarding the definitions of ISS and qSOFA were added to the references. The second version of the manuscript replaces the first version after revisions were made. Changes have been made to the abstract's results. Spelling and punctuation errors have been corrected in the figure captions in introduction. We have added more details to the methodology about the definition of Injury Severity Score (ISS) and quick Sequential Organ Failure Assessment (qSOFA). Additionally, we have made changes to the sentences in the discussion section. Two citations regarding the definitions of ISS and qSOFA were added to the references. See the authors' detailed response to the review by Misauq Mazcuri READ REVIEWER RESPONSES Introduction Thoracic trauma, located on the chest, is an occurrence or incident of an injury that can disturb daily life activities. 1 Trauma will remain one of the main health problems in the world due to its high mortality and morbidity in both developed and developing countries in which the number of deaths in the world caused by trauma reaches around a total of 5.8 million people every year. 2 There are 53% of deaths caused by trauma that happened where the accident occurred, 7.5% of the cases that happened in the emergency room, and a total of 39.5% that happened in the hospitals, 3 of deaths, hospitalizations, and long term disability in the first four decades of life. 2 In Indonesia, the incidence of trauma is still high. The Basic Health Research (Riskesdas) of the Ministry of Health of the Republic of Indonesia in 2018 indicates an increasing number of trauma cases, rising from 8.2% to 9.2%. The occurrence of thoracic trauma in the province of Aceh is 4.1%. 1 More than 90% of trauma-related deaths occur in low-income countries, which is attributed to their larger population compared to high-income countries. 4 Thoracic trauma comprises 20-25% of cases of all trauma cases worldwide. It is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. 2 According to the ATLS protocol, early diagnosis and management of thoracic trauma cases are very important; treatment in the first hours of trauma is the gold standard, it is associated with a greater probability of reducing morbidity and mortality. Thoracic trauma is classified into open (penetrating) and closed (blunt). According to the type of trauma, lesions can be divided into four groups: lesions on the thoracic wall, lesions of the lungs, mediastinum, and diaphragm. The most common lesions are rib fractures and injury to the heart, aorta, and diaphragm. 5 This research was conducted at the Zainoel Abidin General Hospital Banda Aceh, the top referral hospital in the Aceh province. This study aims to see what factors can affect the short-term outcome of trauma patients’ thorax at The Zainoel Abidin General Hospital Banda Aceh. Methods Ethics approval This research has received ETHICAL APPROVAL from the Health Research Ethics Commission of the Faculty of Medicine of the University of Syiah Kuala-DR Zainoel Abidin Hospital (KEPPKN Registration Number: 117101P) by number 301/FK-RSUDZA/2021. Written informed consent was received from the patients. Study design This is an analytic observational study with a retrospective cohort method, and data collection was carried out at the Medical Record Installation of The Zainoel Abidin General Hospital Banda Aceh. Data collection was from August 20 th to October 20 th , 2020. Sampling used a total technique that meets the inclusion criteria, namely patients who are diagnosed with thoracic trauma and are willing to be interviewed by the researcher. The exclusion criteria are all those patients diagnosed with thoracic trauma who have incomplete, not found, and broken data in the medical records files according to the research variables. This study used multivariate data analysis using logistic regression to assess the factors that influence the short-term outcome of thoracic trauma patients. All data analysis was done using IBM SPSS, Statistics standard 25. Results Research on short-term outcome analysis of thoracic trauma patients at The Zainoel Abidin General Hospital Banda Aceh in the 2019-2020 period recorded 260 patients. During data collection at the Medical Record Installation, 169 medical records were obtained, and 91 data were not found. The obtained data recorded a total of 144 patients experiencing thoracic trauma, but three of them did not meet the inclusion and exclusion criteria of the study. The sample in this study amounted to 141 medical records ( Figure 1 ). The Injury Severity Score (ISS) is an anatomical scoring system that provides an overall score for patients with multiple injuries. Each injury is assigned an abbreviated injury scale (AIS) score and is allocated to one of six body regions. 6 The quick Sequential Organ Failure Assessment (qSOFA score) is used to assess organ failure, start or adjust sepsis therapy, refer patients to the ICU, and identify life-threatening infections. 7 Based on, the number of thoracic trauma patients in males is dominating, namely 101 (71.63%) cases. Furthermore, the majority of the length of stay for thoracic trauma patients was less than 7 days, with an average length of stay of 9 days, where there were 63 (44.68%) cases during 2 years of observation. As many as 58 (41.13%) cases were recorded for 7-14 days, and 20 (14.19%) were recorded for >14 days. Regarding the thoracic trauma type, 138 (97.87%) were blunt, and the blunt trauma was caused by traffic accidents on motorcycle users, which recorded as many as 83 (58.7%) cases. In 3 (2.13), patients experience penetrating trauma, mostly caused by being stabbed with iron ( Table 1 ). Figure 1. Flowchart depicting patient enrollment, treatment, and outcomes. MV: Mechanical Ventilation. Table 1. Characteristics based on gender, trauma classification, mechanism of trauma, and length of stay. Variables n(%) Outcome X 2 Alive Dead Gender Male 101(71.63) 91 10 0.65 Female 40(28.37) 37 3 Type Blunt 138(97.87) 125 13 0.57 Penetrating 3(2.13) 3 0 Mechanism Car accidents 13(9.22) 13 0 0.56 Motorbike accidents 83(58.87) 76 7 Fell 42(29.79) 36 6 Stabbed by iron 2(1.42) 2 0 Shot 1(0.71) 1 0 Length of stay 14 days 20(14.18) 20 0 Table 2 shows that the majority of thoracic trauma patients do not use a ventilator, which consists of 122 (86.52%) cases, while those who use a ventilator are recorded as 19 (13.48%) cases. Most patients, exactly as many as 18 (12.77%), use less than 96 hours duration, and 1 (0.71%) patient was recorded to use for more than 96 hours duration. There are 139 (98.58%) thoracic trauma patients who had no complications of sepsis, but 2 (1.42%) thoracic trauma patients were diagnosed with sepsis during hospitalization ( Table 3 ). The qSOFA score in the majority of thoracic trauma patients was 0 in 117 (82.98%) cases, followed by 1 in 19 (13.48%) cases and 2 in 5 (3.55%) cases. Moreover, the injury severity score in the majority of thoracic trauma patients was in the <16 (low) group, namely 87 (61.70%) cases, followed by the 16-30 (moderate) group, which was 54 (38.30%) cases. Table 2. Characteristics based on ventilation, days of ventilation, sepsis, qSOFA and ISS score. Variables n(%) Outcome X 2 Alive Dead Ventilation Yes 19(13.48) 13 5 0.00 No 122(86.52) 114 8 Days of ventilation 0 hours 122(86.52) 114 8 0.01 ≤96 hours 18(12.77) 13 5 >96 hours 1(0.71) 1 0 Sepsis Yes 2(1.41) 0 2 0.00 No 139(98.59) 128 11 qSOFA score 0 117(82.98) 111 6 0.00 1 19(13.47) 17 2 2 5(3.55) 0 5 Injury severity score <16 87(61.70) 85 2 0.00 16-30 54(38.30) 43 11 Table 3. Type of thoracic trauma. Diagnosis Outcome n(%) X 2 Alive Dead Fracture costae 39 3 42(29.77) 0.00 Fracture costae + Fracture Clavicula 21 0 21(14.89) Fracture Clavicula 20 0 20(14.18) Fracture costae + Hemothorax 9 1 10(7.09) Fracture costae + Pulmonary contusion 5 0 5(3.55) Pulmonary Contusion 5 2 7(4.96) Fracture costae + Tension Pneumothorax 3 0 3(2.13) Fracture costae + Pneumothorax 3 0 3(2.13) Fracture costae + Pneumothorax + Pulmonary Contusion 3 0 3(2.13) Hemothorax 5 0 5(3.55) Fracture costae + Fracture Clavicula + Hemothorax 2 1 3(2.13) Fracture costae + Hemothorax + Pulmonary Contusion 2 1 3(2.13) Pneumothorax 2 0 2(1.42) Fracture costae + Fracture Clavicula + Pulmonary Contusion 2 0 2(1.42) Fracture costae + Pneumothorax + Hemothorax 1 0 1(0.71) Fracture costae + Hemothorax + Tension Pneumothorax + Pulmonary Contusion 1 0 1(0.71) Pneumothorax + Pulmonary Contusion 1 0 1(0.71) Fracture costae + Fracture Clavicula + Tension Pneumothorax + Hemothorax 1 0 1(0.71) Fracture thoracic vertebrae 1 0 1(0.71) Hemothorax + Pneumothorax + Pulmonary contusion 1 0 1(0.71) Hemothorax + Pulmonary Contusion 1 1 2(1.42) Flail chest + Hemothorax + Pulmonary Contusion 0 1 1(0.71) Flail chest 0 1 1(0.71) Cardiac Tamponade 0 1 1(0.71) Pneumothorax + Hemothorax 0 1 1(0.71) The majority of patients with thoracic trauma were diagnosed with rib fractures as 42 (29.77%) cases, followed by rib and clavicle fractures in 23 (16.31%) cases, clavicle fractures in 18 (12.77%), pulmonary contusion was recorded in 7 (4.96%) cases, rib fractures with hemothorax in 10 (7.09%) cases, hemothorax and pneumothorax in 5 (3.55%) and 2 (1.42%) cases respectively. In addition, 1 (0.71%) cases of each flail chest and cardiac tamponade ( Table 3 ). In our study, 16 (11.35%) out of 141 patients only needed conservative treatment, including chest physiotherapy and analgesics. In comparison, 125 (88.65%) patients needed operative treatment where open reduction internal fixation (ORIF) with chest tube insertion was the common modality to treat thoracic trauma victims, followed by thoracotomy and video-assisted thoracic surgery (VATS). In addition, decompression of thoracic vertebrae was found in 1 (0.71%) cases ( Table 4 ). Table 4. Type of Management for Thoracic Trauma. Management n(%) Outcome X 2 Alive Dead Conservative 16(11.35) 14 2 0.01 Operative ORIF Costae 26(18.44) 25 1 ORIF Clavicula 17(12.06) 17 0 ORIF Costae + ORIF Clavicula 5(3.55) 5 0 Chest Tube 16(11.35) 10 6 ORIF Costae + Chest Tube 27(19.15) 27 0 ORIF Costae + ORIF Clavicula + Chest Tube 6(4.26) 6 0 Thoracotomy + ORIF Costae + Chest Tube 16(11.35) 12 4 Thoracotomy + ORIF Costae + ORIF Clavicula + Chest Tube 5(3.55) 5 0 Thoracotomy + ORIF Costae 1(0.71) 1 0 VATS + Chest tube 2(1.42) 2 0 VATS + ORIF Costae + Chest Tube 1(0.71) 1 0 VATS + ORIF Costae + ORIF Clavicula + Chest Tube 1(0.71) 1 0 Thoracotomy + Chest Tube 1(0.71) 1 0 Posterior Decompression 1(0.71) 1 0 Discussion Our study shows the highest incidence of thoracic trauma occurred in patients with male gender. Research conducted by Christoporus et al. stated that the reason for the male gender experiencing chest trauma more often was because the level of activity carried out by men was higher than that of women; male occupations are mostly done outside the home. In addition, men tend to pay less attention to safety when driving a motorized vehicle. 8 Based on Table 1 , the majority of thoracic traumas occur due to blunt objects; the increasing incidence of blunt trauma is caused by an increase in population and high traffic flow. The study of Jigar et al. in India stated that the type of injury a geographical area faces depends on civilization, society, culture and industrialization. 9 Meanwhile, penetrating trauma is usually determined by the level of crime and violence that occurs in the community in the area itself. Furthermore, the causes of thoracic trauma with the type of blunt trauma are caused by traffic accidents on motorcycle users, which is recorded as many as 83 (58.7%) cases. During the 2015-2019, traffic accidents increased by 4.87% per year. In the report by the National Police Traffic Corps, it is stated that motorcycle accidents still dominate in Indonesia; this is because the majority of Indonesian people use motorcycles. This can occur due to motorcyclists’ non-compliance with traffic signs and speed when driving a motorized vehicle. The length of stay for chest trauma patients depends on the severity of the trauma and other additional injuries. Many factors affect the length of stays such as the type of injury, complications that occur during treatment, and the treatment in the intensive care unit. 10 The study of Eray et al. said that there was a relationship between oxygen saturation and length of stay, namely the lower the oxygen saturation of trauma patients, the longer the length of stay. In addition, deaths that occur early in treatment are the reason for shorter hospital stays. 11 In this study, the length of stay of patients with chest trauma was less than seven days. A study in Sri Lanka said that the presence of flail chest and injury to the trachea was associated in length of stay patients with chest trauma. 12 According to Table 2 , the presence of pulmonary contusions with or without a flail chest is usually associated with a high incidence of ventilator use. 13 The presence of pulmonary contusions can injure small airways and damage capillaries and epithelial cells. These conditions can cause an increase in pulmonary capillary permeability which will cause alveolar edema. The previous study shows significantly that severe rib fractures were associated with a long mechanical ventilation period. Hence, assessing the extent of rib fractures could estimate the requirement of mechanical ventilation and prolong ICU days. 14 In this study, patients who required the use of a ventilator and had access to it tended to have a high probability of getting a good outcome or living. This is in line with the research conducted by Niloofar et al. in Canada. 15 Moreover, there is a significant relationship between the duration of the ventilator and the short-term outcome of thoracic trauma patients. In this study, patients who did not require a ventilator tended to have a fairly good short-term outcome. Our study reported that 2 out of 141 patients with chest trauma fell into the septic condition. Patients falling into the septic condition is usually caused by open wounds and chest tube insertion. Otherwise, a study in Tanzania revealed that sepsis is the most common complication in chest trauma patients, this difference is caused by the quality of attention provided to patients between the two countries. 16 There was a significant relationship between qSOFA scores and short-term outcomes of thoracic trauma patients. This is in line with the research conducted by Wenjuang et al. in Taiwan in 2021 where the study stated that the higher the qSOFA score of trauma patients, the worse the outcome ( Table 2 ). 17 Furthermore, there is a significant relationship between ISS scores and short-term outcomes of thoracic trauma patients. This is in line with the research conducted by Monafisha et al. in Tanzania which showed that there was a significant relationship between ISS scores and the outcome of thoracic trauma patients. 16 In addition, the study conducted by Sadiye et al. in Turkey also shows the same thing. 18 Based on Table 3 , there is a significant relationship between the diagnosis and the short-term outcome of thoracic trauma patients. This is different from the research from Ethiopia in 2020 that stated that there was no significant relationship between the diagnosis and the outcome of thoracic trauma patients. The difference probably because the study only used primary diagnoses of thoracic trauma patients. 19 Meanwhile, a study in Germany, which examined the outcome of thoracic trauma patients, said that rib fractures indicate death at an advanced age and the number of rib fractures correlates with poor outcomes. Bilateral flail chest is associated with increased mortality and injury to intrathoracic vessels and cardiac lacerations are associated with high mortality and prolonged ventilation also causes significant morbidity in chest trauma patients. 20 Based on Table 4 , there is a significant relationship between management and short-term outcomes of thoracic trauma patients. This is in line with research conducted by Ararso et al. in Ethiopia in 2020 which stated that there was a significant relationship between treatment and outcome of thoracic trauma patients. The study divided the management into conservative and operative which consisted of insertion of a chest tube and thoracotomy. 19 a study conducted by Hafiz in the UK said that surgery performed within the first 48 hours resulted in shorter ICU stays, reduced risk of complications such as pneumonia, shorter hospital stays and shorter use of intensive ventilation overall. 21 Research conducted by Christian et al in Switzerland stated that the return to work rate for 6 months after chest trauma was higher in the open reduction internal fixation (ORIF) group. Symptoms such as subjective dyspnea, chest pain, and chest stiffness were common in the nonoperative group 6-12 months after the trauma. 22 Based on our result in Table 5 , the variable that has a greater influence on the short-term outcome of thoracic trauma patients is the ISS score, in which patients that have a lower ISS score have an 11 times greater chance compared to the patients with the higher ISS score. This is in line with research conducted by Monafisha et al. in Canada where research shows that patients who have a high ISS score have a six times risk of producing a poor outcome. 16 The same thing was also stated by Sadiye et al. In Turkey, where the ISS score is an important prognostic factor in the outcome of thoracic trauma patients, the higher the ISS score, the more severe the trauma. 18 Table 5. Factors associated with a short-term outcome of thoracic trauma. Independent variable Dependent variable B Exp(B) Sig R 2 ISS scores Short-term Outcome 2.386 10.872 0.003 0.193 qSOFA scores Short-term Outcome 2.084 8.035 0.00 0.295 Ventilator duration Short-term Outcome 1.327 3.769 0.023 0.050 Diagnosis Short-term Outcome 0.110 1.116 0.003 0.124 Ventilator Short-term Outcome -1.627 0.196 0.011 0.087 Management/Treatment Short-term Outcome 0.030 1.030 0.758 0.001 Sepsis Short-term Outcome 23.657 187982.584 0.999 0.147 Limitations The limitation of this study is we only used data from Dr. Zainoel Abidin General Hospital, which represent a chest trauma population with a majority of blunt trauma. Furthermore, this study was conducted in the tertiary care hospital, hence, the patients with less severe trauma who have been managed in primary care are underrepresented. Also, patients who had died at the accident scene or at the emergency room were not assessed in our study. Conclusion In summary, thoracic trauma is a public health problem among all trauma admissions at Dr. Zainoel Abidin General Hospital. The majority of chest traumas are caused by road traffic accidents especially motorbikes due to the population of motorbike users being still high. Injury severity score is the most influential factor to the short-term outcome of patients with thoracic trauma, where the lower the ISS score, the greater chance of survival compared to a higher score. Data availability Data cannot be shared due to ethical and security concerns, nevertheless, a dataset with all the details can be shared with reviewer or readers at reasonable request to corresponding author. Author's contributions All authors have read and approved the final manuscript. The requirements for authorship have been met, and each author believes that the manuscript represents honest work. References 1. Kementrian Kesehatan Republik Indonesia: Riset Kesehatan Dasar. 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PubMed Abstract | Publisher Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 20 Apr 2022 ADD YOUR COMMENT Comment Author details Author details 1 Division of Thoracic Cardiac and Vascular Surgery, Department of Surgery, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia 2 Scholar, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia 3 Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia 4 Division of Orthopaedic and Traumatology, Department of Surgery, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia 5 Division of Cardiac Rehabilitation, Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia Yopie Afriandi Habibie Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Widya Anisa Roles: Data Curation, Formal Analysis, Methodology, Project Administration, Software, Validation, Writing – Original Draft Preparation Nurkhalis Nurkhalis Roles: Data Curation, Formal Analysis, Investigation, Methodology Azharuddin Azharuddin Roles: Data Curation, Formal Analysis, Methodology, Supervision, Validation Muhammad Ridwan Roles: Data Curation, Formal Analysis, Methodology, Supervision, Validation Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (2) version 2 Revised Published: 03 Jul 2024, 11:441 https://doi.org/10.12688/f1000research.110976.2 version 1 Published: 20 Apr 2022, 11:441 https://doi.org/10.12688/f1000research.110976.1 Copyright © 2024 Habibie YA et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Habibie YA, Anisa W, Nurkhalis N et al. Analysis on short-term outcomes of patients with thoracic trauma at dr. Zainoel Abidin General Hospital in Banda Aceh [version 2; peer review: 1 approved with reservations] . F1000Research 2024, 11 :441 ( https://doi.org/10.12688/f1000research.110976.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 20 Apr 2022 Views 0 Cite How to cite this report: Mazcuri M. Reviewer Report For: Analysis on short-term outcomes of patients with thoracic trauma at dr. Zainoel Abidin General Hospital in Banda Aceh [version 2; peer review: 1 approved with reservations] . F1000Research 2024, 11 :441 ( https://doi.org/10.5256/f1000research.122642.r239500 ) The direct URL for this report is: https://f1000research.com/articles/11-441/v1#referee-response-239500 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 16 Feb 2024 Misauq Mazcuri , Thoracic Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.122642.r239500 Abstract Background: can occur ( not occurred) or to any gender a life-threatening condition Result: mention % of males , thoracic trauma diagnosis , management of thoracic trauma cannot be variables to tabulate. If management to be considered ... Continue reading READ ALL Abstract Background: can occur ( not occurred) or to any gender a life-threatening condition Result: mention % of males , thoracic trauma diagnosis , management of thoracic trauma cannot be variables to tabulate. If management to be considered need to discuss which form of management. Conclusion : Motorbike as common mode where is it mentioned in abstract result ?? What supports the statement injury severity score as most influential as many others also have similar P value. Introduction : Paragraph 1: Need to use connecting words , last line creating confusion Paragraph 2 : grammatical errors Method : need to abbreviate and maybe briefly introduce readers to ISS score and qSOFA score Result : It is not important to mention how many total patient were there etc. Directly mention 141 cases as you have mentioned your inclusion and exclusion criteria already. Avoid repetition of all results mentioned in table again in text. Eg most common length of stay was less than 7 , mentioning all not necessary (2.13 %) Similar advice for the rest of the result do not repeat all findings , mention only the most common finding Hematothorax ??? 1 case not cases Discussion : seven not sevem Paragraph 3 : you have not tabulated any factor with ventilatory support there fore cannot state you first line. Table 5 is from your own paper ?? , if yes why not mentioned in result Sepsis is not related to short term outcome Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: thoracic pathologies benign , malignant , trauma I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Mazcuri M. Reviewer Report For: Analysis on short-term outcomes of patients with thoracic trauma at dr. Zainoel Abidin General Hospital in Banda Aceh [version 2; peer review: 1 approved with reservations] . F1000Research 2024, 11 :441 ( https://doi.org/10.5256/f1000research.122642.r239500 ) The direct URL for this report is: https://f1000research.com/articles/11-441/v1#referee-response-239500 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 13 Apr 2024 Yopie Afriandi Habibie , Division of Thoracic Cardiac and Vascular Surgery, Department of Surgery, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia 13 Apr 2024 Author Response Background: can occur ( not occurred) or to any gender a life-threatening condition : Thank you for the correction. Result: mention % of males , thoracic trauma diagnosis , management of thoracic ... Continue reading Background: can occur ( not occurred) or to any gender a life-threatening condition : Thank you for the correction. Result: mention % of males , thoracic trauma diagnosis , management of thoracic trauma cannot be variables to tabulate. If management to be considered need to discuss which form of management : Table 1 shows the diagnosis information, while table 3 shows the diagnosis results. Conclusion : Motorbike as common mode where is it mentioned in abstract result ?? : Yes, we will make the correction and include the vehicle that is commonly the cause of accidents. What supports the statement injury severity score as most influential as many others also have similar P value. : already described in table 5 Introduction : Paragraph 1: Need to use connecting words, last line creating confusion : "I appreciate your correction. Thank you for pointing out the mistake. Paragraph 2 : grammatical errors : "I appreciate your correction. Thank you for pointing out the mistake." Method : need to abbreviate and maybe briefly introduce readers to ISS score and qSOFA score Result : It is not important to mention how many total patient were there etc. Directly mention 141 cases as you have mentioned your inclusion and exclusion criteria already. : "I appreciate your correction. Thank you for pointing out the mistake." Avoid repetition of all results mentioned in table again in text. Eg most common length of stay was less than 7 , mentioning all not necessary (2.13 %) Similar advice for the rest of the result do not repeat all findings , mention only the most common finding Hematothorax ??? : "I appreciate the correction you gave me. Thank you." 1 case not cases : Thank you Discussion : seven not sevem : Thank You Paragraph 3 : you have not tabulated any factor with ventilatory support there fore cannot state you first line : Already mentioned on Table 2 Table 5 is from your own paper ?? , if yes why not mentioned in result : Yes, from my own paper. Thank you Sepsis is not related to short term outcome Is the work clearly and accurately presented and does it cite the current literature? : Yes, it cite the current literature Background: can occur ( not occurred) or to any gender a life-threatening condition : Thank you for the correction. Result: mention % of males , thoracic trauma diagnosis , management of thoracic trauma cannot be variables to tabulate. If management to be considered need to discuss which form of management : Table 1 shows the diagnosis information, while table 3 shows the diagnosis results. Conclusion : Motorbike as common mode where is it mentioned in abstract result ?? : Yes, we will make the correction and include the vehicle that is commonly the cause of accidents. What supports the statement injury severity score as most influential as many others also have similar P value. : already described in table 5 Introduction : Paragraph 1: Need to use connecting words, last line creating confusion : "I appreciate your correction. Thank you for pointing out the mistake. Paragraph 2 : grammatical errors : "I appreciate your correction. Thank you for pointing out the mistake." Method : need to abbreviate and maybe briefly introduce readers to ISS score and qSOFA score Result : It is not important to mention how many total patient were there etc. Directly mention 141 cases as you have mentioned your inclusion and exclusion criteria already. : "I appreciate your correction. Thank you for pointing out the mistake." Avoid repetition of all results mentioned in table again in text. Eg most common length of stay was less than 7 , mentioning all not necessary (2.13 %) Similar advice for the rest of the result do not repeat all findings , mention only the most common finding Hematothorax ??? : "I appreciate the correction you gave me. Thank you." 1 case not cases : Thank you Discussion : seven not sevem : Thank You Paragraph 3 : you have not tabulated any factor with ventilatory support there fore cannot state you first line : Already mentioned on Table 2 Table 5 is from your own paper ?? , if yes why not mentioned in result : Yes, from my own paper. Thank you Sepsis is not related to short term outcome Is the work clearly and accurately presented and does it cite the current literature? : Yes, it cite the current literature Competing Interests: I confirm that I have read this review and I do not have any competing of interests Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 13 Apr 2024 Yopie Afriandi Habibie , Division of Thoracic Cardiac and Vascular Surgery, Department of Surgery, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia 13 Apr 2024 Author Response Background: can occur ( not occurred) or to any gender a life-threatening condition : Thank you for the correction. Result: mention % of males , thoracic trauma diagnosis , management of thoracic ... Continue reading Background: can occur ( not occurred) or to any gender a life-threatening condition : Thank you for the correction. Result: mention % of males , thoracic trauma diagnosis , management of thoracic trauma cannot be variables to tabulate. If management to be considered need to discuss which form of management : Table 1 shows the diagnosis information, while table 3 shows the diagnosis results. Conclusion : Motorbike as common mode where is it mentioned in abstract result ?? : Yes, we will make the correction and include the vehicle that is commonly the cause of accidents. What supports the statement injury severity score as most influential as many others also have similar P value. : already described in table 5 Introduction : Paragraph 1: Need to use connecting words, last line creating confusion : "I appreciate your correction. Thank you for pointing out the mistake. Paragraph 2 : grammatical errors : "I appreciate your correction. Thank you for pointing out the mistake." Method : need to abbreviate and maybe briefly introduce readers to ISS score and qSOFA score Result : It is not important to mention how many total patient were there etc. Directly mention 141 cases as you have mentioned your inclusion and exclusion criteria already. : "I appreciate your correction. Thank you for pointing out the mistake." Avoid repetition of all results mentioned in table again in text. Eg most common length of stay was less than 7 , mentioning all not necessary (2.13 %) Similar advice for the rest of the result do not repeat all findings , mention only the most common finding Hematothorax ??? : "I appreciate the correction you gave me. Thank you." 1 case not cases : Thank you Discussion : seven not sevem : Thank You Paragraph 3 : you have not tabulated any factor with ventilatory support there fore cannot state you first line : Already mentioned on Table 2 Table 5 is from your own paper ?? , if yes why not mentioned in result : Yes, from my own paper. Thank you Sepsis is not related to short term outcome Is the work clearly and accurately presented and does it cite the current literature? : Yes, it cite the current literature Background: can occur ( not occurred) or to any gender a life-threatening condition : Thank you for the correction. Result: mention % of males , thoracic trauma diagnosis , management of thoracic trauma cannot be variables to tabulate. If management to be considered need to discuss which form of management : Table 1 shows the diagnosis information, while table 3 shows the diagnosis results. Conclusion : Motorbike as common mode where is it mentioned in abstract result ?? : Yes, we will make the correction and include the vehicle that is commonly the cause of accidents. What supports the statement injury severity score as most influential as many others also have similar P value. : already described in table 5 Introduction : Paragraph 1: Need to use connecting words, last line creating confusion : "I appreciate your correction. Thank you for pointing out the mistake. Paragraph 2 : grammatical errors : "I appreciate your correction. Thank you for pointing out the mistake." Method : need to abbreviate and maybe briefly introduce readers to ISS score and qSOFA score Result : It is not important to mention how many total patient were there etc. Directly mention 141 cases as you have mentioned your inclusion and exclusion criteria already. : "I appreciate your correction. Thank you for pointing out the mistake." Avoid repetition of all results mentioned in table again in text. Eg most common length of stay was less than 7 , mentioning all not necessary (2.13 %) Similar advice for the rest of the result do not repeat all findings , mention only the most common finding Hematothorax ??? : "I appreciate the correction you gave me. Thank you." 1 case not cases : Thank you Discussion : seven not sevem : Thank You Paragraph 3 : you have not tabulated any factor with ventilatory support there fore cannot state you first line : Already mentioned on Table 2 Table 5 is from your own paper ?? , if yes why not mentioned in result : Yes, from my own paper. Thank you Sepsis is not related to short term outcome Is the work clearly and accurately presented and does it cite the current literature? : Yes, it cite the current literature Competing Interests: I confirm that I have read this review and I do not have any competing of interests Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 20 Apr 2022 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 Version 2 (revision) 03 Jul 24 Version 1 20 Apr 22 read Misauq Mazcuri , Jinnah Postgraduate Medical Centre, Karachi, Pakistan Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Mazcuri M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 16 Feb 2024 | for Version 1 Misauq Mazcuri , Thoracic Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan 0 Views copyright © 2024 Mazcuri M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Abstract Background: can occur ( not occurred) or to any gender a life-threatening condition Result: mention % of males , thoracic trauma diagnosis , management of thoracic trauma cannot be variables to tabulate. If management to be considered need to discuss which form of management. Conclusion : Motorbike as common mode where is it mentioned in abstract result ?? What supports the statement injury severity score as most influential as many others also have similar P value. Introduction : Paragraph 1: Need to use connecting words , last line creating confusion Paragraph 2 : grammatical errors Method : need to abbreviate and maybe briefly introduce readers to ISS score and qSOFA score Result : It is not important to mention how many total patient were there etc. Directly mention 141 cases as you have mentioned your inclusion and exclusion criteria already. Avoid repetition of all results mentioned in table again in text. Eg most common length of stay was less than 7 , mentioning all not necessary (2.13 %) Similar advice for the rest of the result do not repeat all findings , mention only the most common finding Hematothorax ??? 1 case not cases Discussion : seven not sevem Paragraph 3 : you have not tabulated any factor with ventilatory support there fore cannot state you first line. Table 5 is from your own paper ?? , if yes why not mentioned in result Sepsis is not related to short term outcome Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise thoracic pathologies benign , malignant , trauma I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 13 Apr 2024 Yopie Afriandi Habibie, Division of Thoracic Cardiac and Vascular Surgery, Department of Surgery, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia Background: can occur ( not occurred) or to any gender a life-threatening condition : Thank you for the correction. Result: mention % of males , thoracic trauma diagnosis , management of thoracic trauma cannot be variables to tabulate. If management to be considered need to discuss which form of management : Table 1 shows the diagnosis information, while table 3 shows the diagnosis results. Conclusion : Motorbike as common mode where is it mentioned in abstract result ?? : Yes, we will make the correction and include the vehicle that is commonly the cause of accidents. What supports the statement injury severity score as most influential as many others also have similar P value. : already described in table 5 Introduction : Paragraph 1: Need to use connecting words, last line creating confusion : "I appreciate your correction. Thank you for pointing out the mistake. Paragraph 2 : grammatical errors : "I appreciate your correction. Thank you for pointing out the mistake." Method : need to abbreviate and maybe briefly introduce readers to ISS score and qSOFA score Result : It is not important to mention how many total patient were there etc. Directly mention 141 cases as you have mentioned your inclusion and exclusion criteria already. : "I appreciate your correction. Thank you for pointing out the mistake." Avoid repetition of all results mentioned in table again in text. Eg most common length of stay was less than 7 , mentioning all not necessary (2.13 %) Similar advice for the rest of the result do not repeat all findings , mention only the most common finding Hematothorax ??? : "I appreciate the correction you gave me. Thank you." 1 case not cases : Thank you Discussion : seven not sevem : Thank You Paragraph 3 : you have not tabulated any factor with ventilatory support there fore cannot state you first line : Already mentioned on Table 2 Table 5 is from your own paper ?? , if yes why not mentioned in result : Yes, from my own paper. Thank you Sepsis is not related to short term outcome Is the work clearly and accurately presented and does it cite the current literature? : Yes, it cite the current literature View more View less Competing Interests I confirm that I have read this review and I do not have any competing of interests reply Respond Report a concern Mazcuri M. Peer Review Report For: Analysis on short-term outcomes of patients with thoracic trauma at dr. Zainoel Abidin General Hospital in Banda Aceh [version 2; peer review: 1 approved with reservations] . F1000Research 2024, 11 :441 ( https://doi.org/10.5256/f1000research.122642.r239500) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/11-441/v1#referee-response-239500 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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