The effect of sternum and denim fractures on mortality and prognosis in patients with thoracic trauma administering to emergency service

The majority of trauma patients admitted to the emergency department who lost their lives constitute thoracic trauma. The rate of thoracic traumas among traumas is around 10-15%, and the mortality rate due to trauma is around 25%. Although the mortality rate in sternum fractures is over 0.7%, it is known that the mortality rate increases up to 25-40%, especially if fractures are accompanied by dislocations and mediastinal hemorrhage, myocardial contusion and vascular lesions. In our study, 152 patients who were diagnosed with sternum fractures on computed tomography taken from patients who were admitted to Dicle University Medical Faculty Emergency Medicine and Traumatology Department Adult Emergency Service between 07.09.2009 and 01.09.2019. Mortality was investigated for additional thoracic injuries, location and type of sternum fracture, diagnostic methods applied, NISS and ISS score due to the presence of cardiac injury. 124 (82%) of the patients were male and 28 (13%) were female. 95 (62%) of the patients were AITK, 20 (13%) were ADTK, 7 (5%) were ASY, 16 (11%) were falling from a height, 10 (7%) were in motorcycle accident, 4 (3%) was assaulted. Cardiac injury in 85 (55.9%) patients, rib fracture in 101 (66%), pneumothorax in 73 (48%), hemothorax in 77 (51%), pneumomediastinum in 15 (10%), 80 ' lung contusion in 19 (53%), lung laceration in 23 (15%), intracranial bleeding in 27 (18%), facial injuries in 17 (11%), extremity and pelvic injuries in 37 (24%), There were abdominal organ injuries in 15 (10%), scapula fracture in 24 (16%), clavicle fracture in 13 (9%), and thoracalvertebrafracture in 45 (30%). According to the location and type of sternum fracture of the patients, 94 (62%) had manubrium fracture, 54 (36%) had corpus fracture, 4 (3%) had manubrium + corpus, 84 (55%) had displaced fracture, 68 ' (45%) had non-displaced fractures, 33 (22%) had displaced comminuted fractures. 44 (30%) of the patients were troponin positive, 27 (18%) of them had cardiac injury on ECHO. NISS score of the patients was 42.31 + 13.12 in patients with cardiac injury and 34.92 + 11.78 in those with ISS score. Twelve of our patients with 152 sternum fractures died, and the mortality rate was 7.8%. In conclusion, sternum fractures should be diagnosed early, because we concluded that their mortality is high and mortality increases even more with additional pathologies. Keywords: sternum, fracture, heart injury, mortality