Thoracic trauma in intensive care: A ten-year retrospective cohort study from a regional trauma unit

Background Thoracic trauma accounts for a significant proportion of major injuries requiring intensive care. The Galway University Hospital (GUH) serves as a key regional trauma unit, and understanding historical trends is essential for planning trauma service. Thus, this review aimed to describe the demographics, injury patterns, interventions, complications, and outcomes of patients with thoracic trauma admitted to the GUH intensive care unit (ICU) between 2011 and 2020. Methods A retrospective observational study was conducted, including all adult patients admitted to the GUH ICU for thoracic trauma between January 2011 and December 2020. These cases were identified using the Metavision and NIMIS databases. The primary outcome was 30-day mortality, and the secondary outcomes included complication burden, ICU length of stay (LOS), and the need for thoracic surgery. Data were anonymised and analysed using Minitab Statistical Software. Results A total of 250 patients were included in the study. The cohort was predominantly male (77.2%) with a mean age of 50.9 years old. Road traffic accidents were the leading mechanism of injury in patients aged < 65 years (60.2%), whereas falls predominated in those aged ≥ 65 years (48.8%). Rib fractures (66%) and pulmonary contusions (46%) were the most common injuries. Polytrauma occurred in 83% of the patients, and traumatic brain injury occurred in 36%. Only 1% of patients required thoracotomy. Thirty-day mortality was 12%, rising to 15.9% at one year. Complication-free survival was observed in 38% of the patients. Conclusion Thoracic trauma ICU admissions at GUH increased over the decade, with clear age-related injury patterns and low rates of thoracic surgical interventions. These findings support ongoing trauma service development aligned with the Trauma System Implementation Program (TSIP) to improve outcomes through standardised and specialised care.