Detection of Chest Trauma With Whole-Body Low-Dose Linear Slit Digital Radiography: A Multireader Study

Szücs-Farkas, Zsolt; Kaelin, Irene; Flach, Patricia M.; Rosskopf, Andrea B.; Ruder, Thomas D.; Triantafyllou, Maria; Zimmermann, Heinz; Vock, Peter; Bonél, Harald

doi:10.2214/ajr.09.3378

Cited by 8 publications

(6 citation statements)

References 18 publications

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“…CT scan diagnosis of rib fracture is more sensitive than chest x-ray and is also better at identifying parenchymal injury. 22,23 The increased rate of detection with CT has led to a decreased mortality rate associated with rib fractures over time as compared with chest x-ray. Multiple fractures at multiple locations or parenchymal injury may be better predictors of pulmonary failure.…”

Section: Discussionmentioning

confidence: 99%

Increasing Numbers of Rib Fractures Do Not Worsen Outcome: An Analysis of the National Trauma Data Bank

Whitson

McGonigal

Anderson

et al. 2013

The American Surgeon™

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Increasing age and number of rib fractures are thought to portend a worse outcome with blunt chest trauma, although this is not clearly substantiated in the literature. We hypothesized that these parameters have a significant and synergistic effect, worsening patient outcome. Using the National Trauma Data Bank, we evaluated patients from 2002 to 2006. Patients with a rib fracture International Classification of Diseases, 9th Revision code were included; those with sternal fractures were excluded. Data on demographics, injury, comorbidity, complications, intensive care unit duration, ventilator duration, length of stay, and death were collected. Significant univariate predictors were included in the multivariate logistic regression analysis to adjust for any potential confounders. We identified 35,467 patients who met the inclusion. The mean age was 45.5 years with a mean Injury Severity Score of 19.3. There were 2.1 per cent open rib fractures. Using univariate analysis, rib fracture number was significant. However, once multivariate analyses were applied, the number of rib fractures was not found to be an independent predictor of outcome. The number of rib fractures is not an independent predictor of outcome. Age and overall trauma burden are more powerful predictors of poor outcomes. Treatment focus should shift from the chest to the broader scope of injuries and comorbidities.

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Section: Discussionmentioning

confidence: 99%

Increasing Numbers of Rib Fractures Do Not Worsen Outcome: An Analysis of the National Trauma Data Bank

Whitson

McGonigal

Anderson

et al. 2013

The American Surgeon™

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“…The most common types of collateral damage that result from chest trauma include injuries to ribs, lung contusion, hematoma of the chest wall, pleural effusion, pneumothorax and hematothorax. [4–6]…”

Section: Introductionmentioning

confidence: 99%

Ventilation in chest trauma

Richter

Ragaller

2011

J Emerg Trauma Shock

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Chest trauma is one important factor for total morbidity and mortality in traumatized emergency patients. The complexity of injury in trauma patients makes it challenging to provide an optimal oxygenation while protecting the lung from further ventilator-induced injury to it. On the other hand, lung trauma needs to be treated on an individual basis, depending on the magnitude, location and type of lung or chest injury. Several aspects of ventilatory management in emergency patients are summarized herein and may give the clinician an overview of the treatment possibilities for chest trauma victims.

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“…18 They used an excess relative risk (ERR) model to compare different follow-up schemes. Their results demonstrated an ERR of solid organ cancer of 0.43 in younger patients (50)(51)(52)(53)(54)(55) when comparing pure CT surveillance with mixed modality surveillance. This risk declined with increasing age at intervention.…”

Section: Patient Exposure During Evarmentioning

confidence: 98%

“…18 A number of studies have investigated the effects of lowering CT tube current and reducing voltages, showing significant reductions in radiation exposure and contrast administration while maintaining image quality. [50][51][52][53][54][55][56][57] Tube current, expressed in milliamperes, is a parameter that affects the quantity of photons generated by the x-ray tube. Tube voltage is the energy and quantity of the photons generated by the tube.…”

Section: Patient Exposure During Evarmentioning

confidence: 99%

“…Tube voltage is the energy and quantity of the photons generated by the tube. 3 It has been shown that reduction in tube voltages in thin patients can produce adequate quality diagnostic images, 52,55,58 resulting in a 31% to 88% radiation dose reduction. [59][60][61] These lower energy photons interact more strongly with iodinated contrast, resulting in increased lumen attenuation and increased contrast with surrounding tissues.…”

Section: Patient Exposure During Evarmentioning

confidence: 99%

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Review of the Use of Ionizing Radiation in Endovascular Aneurysm Repair

2014

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Detection of Chest Trauma With Whole-Body Low-Dose Linear Slit Digital Radiography: A Multireader Study

Abstract: Linear slit DR is a reliable substitute for CR in the initial evaluation of chest trauma, with better sensitivity for detecting rib fractures and similar performance in assessing pneumothorax and lung contusion.

Cited by 8 publications

References 18 publications

Increasing Numbers of Rib Fractures Do Not Worsen Outcome: An Analysis of the National Trauma Data Bank

Increasing Numbers of Rib Fractures Do Not Worsen Outcome: An Analysis of the National Trauma Data Bank

Ventilation in chest trauma

Review of the Use of Ionizing Radiation in Endovascular Aneurysm Repair

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