Assessing Radiologic Findings of Chest Radiographs in Patients with Trauma Admitted to the Emergency Room

Abstract

Background: According to Advanced Trauma Life Support, chest radiography must be performed during the initial evaluation of patients with trauma. We studied the CXR performed in the emergency room of Rajaie Hospital to determine its usefulness. Methods: In this prospective study, patients who referred with high-energy trauma from December 2013 until April 2014 were recruited. Their demographic characteristics, including age, gender, and cause of trauma were recorded. Meticulous medical history was taken from all patients and they were examined by emergency medicine specialist. Simple radiographic CXR was performed for selective patients and image findings and their mediastinal width were recorded. All statistical analysis was performed using SPSS software version 20.0 and P-value less than 0.05 was considered significant. Results: Of the total 790 patients assessed, 137 patients were female (17.3%) and 655 were male (82.7%). Mean age of patients was 35.13±17.01 (ranging from 12 to 91); Mean mediastinal width was 80.9±11.45 mm (range: 49.2-142.29). The most common causes of trauma included car-to-patient accident in 131 patients (16.5%), motor-to-car accident in 128 patients (16.2%), car turnover in 103 (13%), falling down in 93 (11.7%), and stab wound 88 (11.1%). The most common pathologic finding included rib fractures (42.7%), pneumothorax (11.6%), abnormal diaphragmatic findings (10.3%), and hemothorax (8.3%). Conclusion: The results of the current study, in accordance to previous studies, suggest rib fractures, pneumothorax, abnormal diaphragmatic findings, and hemothorax as the most frequent findings in CXR that need to be assessed meticulously. Moreover, the majority of patients were young males and the most frequent causes of trauma included car accidents, falling down, and stab wound. Therefore, paying attention to their diagnosis and treatment may increase the survival of this important group of patients.