Patterns, management and outcomes of chest trauma in a rural tertiary care hospital in North Kashmir: a prospective observational study

Abstract

Background: Chest trauma remains a critical cause of morbidity and mortality, especially in rural and resource-limited settings. The heterogeneity in injury mechanisms and limitations in emergency infrastructure often pose major challenges in timely diagnosis and management. In North Kashmir, civilian trauma accounts for the majority of cases, while conflict-related injuries contribute a smaller but clinically relevant subset. To analyze the clinical profile, modes of injury, types of chest injuries, management strategies and outcomes of patients presenting with chest trauma at a rural tertiary care hospital GMC Baramulla in North Kashmir over a five-year period. Methods: This is a Prospective observational study of 430 patients presenting with chest trauma from July 2020 to July 2025 from GMC Baramulla. Data on demographics, type of trauma, injury patterns, treatment modalities, complications and hospital stay  were analyzed using descriptive statistics and expressed as frequencies and percentages using standard statistical software. Results: Blunt trauma accounted for 90.6% of cases, predominantly affecting males (74.4%). Road traffic accidents were the leading cause (46.5%), followed by falls (42.7%). Rib fractures and pulmonary contusions were the most common injuries. Most patients were managed conservatively (53.4%), while 30.2% required intercostal tube drainage and 15.8% underwent thoracotomy. Major morbidities included bronchopleural fistula (1.3%) and empyema (0.2%). More than half of the patients (58.1%) were discharged within five days. Conclusions: In rural healthcare settings, structured protocols and timely interventions can effectively manage chest trauma with favorable outcomes. Strengthening trauma systems and referral pathways can further improve care delivery.