Pattern and injury severity score in thoraco-abdominal trauma: A cross-sectional study in medicolegal autopsy cases

Thoracoabdominal injury in various forms is one of the major causes of mortality in majority of the cases brought for medicolegal autopsies. The study aims at assessing the pattern of thoracoabdominal injuries in medicolegal autopsy cases and to correlate injury severity score (ISS) with survival period in these cases. It was observed that thoracoabdominal trauma cases accounted for 77 of the total 350 cases of medicolegal autopsies. The most commonly involved age group was >30-40 years (31%) and the commonest causative agent of thoracoabdominal trauma was road traffic accidents (71.4%) followed by firearm injury (19.4%). Majority of the road traffic accidents occurred on highways (85.4%) and the commonest offending vehicles were cars (36.3%). Majority of the victims in road traffic accidents were pedestrians (47.2%). The most common thoracic organ involved was the lung (30%) and ribs were fractured in 32.5% of the cases. Haemorrhagic shock with head injury was the cause of death in 50.7% of cases. The mean survival period of the victims was 2.56+/-5.4 hours (range 0 to 36). Victims with low ISS survived longer than victims with high ISS, and the mean ISS was 38+/- 13 (range 17 to 66). Some of the deaths in the present study were preventable if there was adequate transportation facility for these victims of trauma and presence of the well-equipped trauma centres near the highways.