Introduction Blunt chest trauma is the second leading cause of death among trauma patients in the world and is also associated with poly trauma. 1 Blunt thoracic trauma can result in significant morbidity in injured patients, both chest wall and the intra-thoracic visceral injuries can lead to life- threatening complications if not anticipated and treated. 2 Early identification and aggressive management of blunt thoracic trauma is essential to reduce the significant rates of morbidity and mortality. 3 Pain control, aggressive pulmonary toilet, and mechanical ventilation when necessary are the mainstays of supportive treatment. The elderly with blunt chest trauma are especially at risk for pulmonary deterioration post-injury and should be monitored carefully regardless of their initial presentation. Blunt thoracic trauma is also a marker for associated injuries, including severe head and abdominal injuries. 4 Traumatic injuries still constitute one of the leading causes of death in all age groups, 5,6 with penetrating and blunt thoracic trauma accounting for 25-50% of all injuries, as well as being a contributing cause in 50% of fatal civilian trauma. 7 The majority of patients with thoracic trauma can be managed non-operatively, with or without tube thoracostomy. 8 As a result, careful monitoring of vital signs, appropriate fluid replacement and analgesia constitute adequate therapy in up to 90% of such patients. However, there is still a small, but significant (10-15%), subgroup of thoracic trauma victims who require emergency thoracotomy. 9 Thoracic trauma is one of the most common injuries in multiple trauma patients and has major prognostic relevance with regard to an increased risk for the development of post-traumatic complications and unfavourable outcome. 10 A prompt and accurate assessment of trauma diagnosis and injury severity is crucial for the further treatment and diagnostic procedures. The present study aimed to provide the overview of outcomes of 264 patients with blunt thoracic trauma reported to emergency department (ED) within 48 hours of trauma in two different public and private sector hospitals in Rawalpindi, Pakistan. Patients and Methods The prospective study was conducted during March 2008- February 2012 over a period of 4 years in surgical wards of a public and a private sector hospitals in Rawalpindi. Among 2008-10, 221 patients were included from the Vol. 64, No. 4, April 2014 375 ORIGINAL ARTICLE Blunt thoracic trauma — an analysis of 264 patients in Rawalpindi, Pakistan Shahzadi Samar Subhani, 1 Mohammad Sultan Muzaffar, 2 Farah Rashid Siddiqui 3 Abstract Objective: To analyse the outcome in terms of morbidity and mortality in blunt thoracic trauma patients in tertiary care hospitals, Rawalpindi. Methods: The prospective study was conducted from March 2008 to February 2012 in surgical wards of public and private sector hospitals in Rawalpindi. A total of 221 patients were included from the Combined Military Hospital during 2008-10, and 43 patients from the Heart's International during 2011-12. The patients reported to emergency department within 48 hours of trauma. All patients were subjected to detailed history and respiratory system examination to ascertain fracture of ribs, flail segment and haemopneumothorax. The diagnosis of chest wall injuries, parenchymal pulmonary injuries and pleural involvement were made on the basis of chest radiographs and computed tomography scan of the chest. The lung contusion was assessed by the number of lobes involved. SPSS 19 was used for statistical analysis. Results: Of the 264 patients in the study, 211 (80%) were males and 54 (20%) females. The overall mean age was 44.8±17.1 years. Over all morbidity was 222 (84.2%); morbidity (minor) was 128 (48.5%), and morbidity (major) was 94 (35.7%). Mortality was 26 (9.8%) and 16 (6%) cases had normal outcome. Conclusion: Early identification and aggressive management of blunt thoracic trauma is essential to reducing significant rates of morbidity and mortality. Keywords: Blunt chest trauma, Poly trauma, Thoracic trauma, Blunt thoracic trauma. (JPMA 64: 375; 2014) 1,2 Department of Surgery, 3 Department of Community Medicine, Yusra Medical and Dental College, Islamabad. Correspondence: Shahzadi Samar Subhani. Email: drsamars@gmail.com