A Clinical and Demographic Analysis of Patients with Flail Chest Injuries in a Tertiary Care Hospital - A Cross-Sectional Study

Background: Flail chest is a severe thoracic injury most often caused by road traffic accidents and is associated with high morbidity and mortality.Central flail chest, due to its anatomical involvement, may present with greater clinical severity and poorer outcomes.This study aimed to compare the demographics, clinical characteristics, including associated thoracic injuries, treatment modalities, and outcomes of patients with flail chest injuries.Methods: This cross-sectional study was conducted in the Department of Thoracic Surgery, National Institute of Diseases of Chest & Hospital (NIDCH), Dhaka, Bangladesh, from January 2010 to December 2010.This study included 60 patients with flail chest injuries divided into two groups: Group I (patients with central flail) and Group II (patients with other types of flails).Results: Road traffic accidents were the predominant cause of injury in both groups.Patients with central flail had a significantly higher mean number of rib fractures (9 2 vs. 5 1; p < 0.001) and higher frequencies of cyanosis (40.9% vs. 15.8%;p = 0.030), lung contusion (59.1% vs. 23.7%;p = 0.006), and surgical emphysema (59.1% vs. 23.7%;p = 0.006).Although pneumonia and ARDS were more frequent in Group I, the differences were not statistically significant.Mortality was significantly higher in central flail patients (22.7% vs. 2.7%; p = 0.023).Conclusion: Central flail chest is associated with more severe injury patterns and significantly greater mortality compared to other types of flail chest.Conservative management remains the cornerstone of treatment; however, heightened vigilance and aggressive supportive care are crucial in cases of central flail.