A trauma center should be consulted to diagnose chest wall instability, a potentially fatal illness. Although patients with unstable chest walls were directed to various levels of trauma centers, the effect on patient outcomes had not yet been studied. For a study, researchers looked at individuals with unstable chest walls who received care at various trauma center levels and survived a hospital release.

The National Trauma Data Bank (NTDB) 2017 dataset was used as the source for the data in the observational retrospective cohort analysis. Adult patients with chest wall instability or deformity and whose ED disposition was documented made up the research sample. There was a descriptive analysis. The primary independent variable, “trauma classification level,” was used to compare hospital data, patient demographic and clinical features, and dispositions. After adjusting for the majority of the retrieved characteristics from NTDB used in the study that was used to perform it, LASSO regression was used to examine the effect of the trauma classification level on patients’ survival.

A total of 1,172 individuals with unstable or deformed chest walls made up the research sample. Fifty-two years old was the median age of the patients, who were 78.2% male. A majority (51.5%) were taken to level I, and 43.2% were sent to trauma hospitals at level II. It took 78.2% of patients to survive to be released from the hospital. Confounding variables were taken into account, and there was no difference in patient survival between those who were brought to level II [OR = 1.000; 95% CI: 0.976–1.025] or level III [OR = 1.000; 95% CI: 0.993–1.007]  trauma centers and those who were taken to level I facilities.

When patients with unstable chest walls were sent to level II or level III centers rather than level I centers, the survival rates were comparable. The study emphasized the need for greater outcome research in structured trauma systems and can assist in direct pre-hospital field triage criteria for the particular type of injury.

Reference: sciencedirect.com/science/article/pii/S0735675722006064