Haemothorax after rib fracture — Incidence, timing and prediction

McLoughlin, Raymond F.; Mulcahy, R; Kent, Peter D.; Al-delamie, Taha Yas; Aherne, Thomas

doi:10.1007/bf02954634

Cited by 12 publications

(13 citation statements)

References 3 publications

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“…In effect, most complications occur less than 7 days posttrauma. 3,[5][6][7][8][9]20 In fact, 87.0% of delayed complications in our study were diagnosed during the first week and only 13.0% during the second week posttrauma. AA 5 ambient air; DBP 5 diastolic blood pressure; HR 5 heart rate; RR 5 respiration rate; SBP 5 systolic blood pressure.…”

Section: Discussionmentioning

confidence: 93%

“…A review of past literature regarding risk factors indicated that age and the number of fractured ribs are significant risk factors for delayed complications. [3][4][5][6][7][8][9] Our prospective study provides a different angle by examining a new variable, the location of the fractures, which makes the previous factors secondary. In effect, after adjusting for all potentially confounding factors, the only risk factor that remains statistically significant is the location of the fractured ribs.…”

Section: Discussionmentioning

confidence: 99%

“…2 Yet they are at risk for developing delayed pulmonary complications. [3][4][5][6][7][8][9] The only prospective cohort study on the topic shows that in the first 2 weeks following a minor blunt thoracic trauma, 7.4% of patients had developed a delayed hemothorax and 2.0% a delayed pneumothorax. That study, which examined a low-risk population, identified a correlation between the number of rib fractures and the presence of delayed hemothorax.…”

Section: Ré Sumémentioning

confidence: 99%

“…3 Retrospective studies report that the number of rib fractures, age, and the presence of subcutaneous emphysema are the main risk factors for delayed pulmonary complications. [4][5][6][7][8][9] At this time, no prospective studies have confirmed these results. There is therefore no consensus in the medical literature regarding follow-up for patients suffering from minor blunt thoracic trauma.…”

Section: Ré Sumémentioning

confidence: 99%

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Cohort Study on the Prevalence and Risk Factors for Delayed Pulmonary Complications in Adults Following Minor Blunt Thoracic Trauma

Plourde

Émond

Lavoie

et al. 2014

CJEM

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Objectives: The objectives of this study are to determine the prevalence, risk factors, and time to onset of delayed hemothorax and pneumothorax in adults who experienced a minor blunt thoracic trauma. Method: A prospective cohort of 450 consecutive patients was recruited. Eligible patients had to be over 16 years of age, consulted within 72 hours for a trauma, and available for outpatient follow-up at 2, 7, and 14 days posttrauma. The clinical outcome investigated was the presence of delayed pneumothorax or hemothorax on the follow-up chest x-ray. Outcomes: Delayed hemothorax occurred in 11.8% (95% CI 8.8-14.8), and delayed pneumothorax occurred in 0.9% (95% CI 0.2-2.3) of participants. During the 14-day follow-up period, 87.0% of these delayed complications developed in the first week. In the multivariate analysis, the only statistically significant risk factor for delayed complications was the location of fractures on the x-ray of the hemithorax. The adjusted odds ratio was 1.52 (95% CI 0.62-3.73) for the lower ribs (tenth to twelfth rib), 3.11 (95% CI 1.60-6.08) for the midline ribs (sixth to ninth rib), and 5.05 (95% CI 1.80-14.19) for the upper ribs (third to fifth rib) versus patients with no fractures. Conclusion: The presence of at least one rib fracture between the third and ninth rib on the x-ray of the hemithorax is a significant risk factor for delayed hemothorax and pneumothorax. RÉ SUMÉObjectifs: Les objectifs de cette é tude consistent à dé terminer la pré valence, les facteurs de risque, et le dé lai d'apparition de l'hé mothorax et du pneumothorax tardifs chez les adultes ayant subi un traumatisme thoracique mineur fermé . Mé thode: Une cohorte prospective de 450 patients consé cutifs a é té recruté e. Les patients é ligibles devaient ê tre â gé s de plus de 16 ans, avoir consulté en deç à de 72 heures pour un traumatisme et ê tre disponibles pour un suivi ambulatoire à 2, 7, et 14 jours suivant le traumatisme. Le ré sultat clinique recherché é tait la pré sence d'hé mothorax et de pneumothorax tardifs à la radiographie pulmonaire de contrô le. Ré sultats: L'hé mothorax tardif est survenu chez 11,8% (IC 95% 8,(8)(9)(10)(11)(12)(13)(14)8) and le pneumothorax tardif chez 0.9% (IC 95% 0,2-2,3%) des participants. Au cours de la pé riode de suivi de 14 jours, 87,0% de ces complications tardives se sont manifesté es durant la premiè re semaine. En analyse multivarié e, le seul facteur de risque de complications tardives statistiquement significatif é tait la localisation des fractures sur la radiographie de l'hé mithorax. Le rapport de cote ajusté se situe à 1,52 (IC 95% 0,62-3,73) pour les cô tes infé rieures (10-12e cô te), à 3,11 (IC 95% 1,6-6,08) pour les cô tes mé dianes (6-9e cô te), et à 5,05 (IC 95% 1,80-14,19) pour les cô tes supé rieures (troisiè me-cinquiè me cô te) par rapport aux patients sans fracture. Conclusion: La pré sence d'au moins une fracture de cô te entre la troisiè me et la neuviè me cô te à la radiographie de l'hé mithorax est un facteur de risque significatif d'hé ...

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Ré Sumémentioning

confidence: 99%

Section: Ré Sumémentioning

confidence: 99%

See 2 more Smart Citations

Cohort Study on the Prevalence and Risk Factors for Delayed Pulmonary Complications in Adults Following Minor Blunt Thoracic Trauma

Plourde

Émond

Lavoie

et al. 2014

CJEM

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show abstract

“…27,31,32 Most studies have reported that patients with at least 1 rib fracture represented about 90% of cases of delayed hemothorax; 14,18,33,34 however, delayed hemothorax also has been reported in the absence of rib fractures. 16,18 One retrospective study reported a prodrome of pain and acute dyspnea in 82% of emergency patients with delayed hemothorax after discharge, 17 whereas other prospective prediction studies reported that the presence of thoracic contusions alone could represent a predictive factor for delayed complications.…”

Section: Discussionmentioning

confidence: 99%