| 1 | Chest X-rays in detecting injuries caused by blunt trauma显示文摘BACKGROUND:The appropriate sequence of different imagings and indications of thoracic computed tomography(TCT)in evaluating chest trauma have not yet been clarified at present.The current study was undertaken to determine the value of chest X-ray(CXR)in detecting chest injuries in patients with blunt trauma.METHODS:A total of 447 patients with blunt thoracic trauma who had been admitted to the emergency department(ED)in the period of 2009–2013 were retrospectively reviewed.The patients met inclusion criteria(age>8 years,blunt injury to the chest,hemodynamically stable,and neurologically intact)and underwent both TCT and upright CXR in the ED.Radiological imagings were re-interpreted after they were collected from the hospital database by two skilled radiologists.RESULTS:Of the 447 patients,309(69.1%)were male.The mean age of the 447 patients was 39.5±19.2(range 9 and 87 years).158(35.3%)patients were injured in motor vehicle accidents(MVA).CXR showed the highest sensitivity in detecting clavicle fractures[95%CI 78.3(63.6–89)]but the lowest in pneuomediastinum[95%CI 11.8(1.5–36.4)].The specificity of CXR was close to 100%in detecting a wide array of entities.CONCLUSION:CXR remains to be the first choice in hemodynamically unstable patients with blunt chest trauma.Moreover,stable patients with normal CXR are candidates who should undergo TCT if significant injury has not been ruled out. | Kadir Agladioglu Mustafa Serinken Onur Dal Halil Beydilli Cenker Eken Ozgur Karcioglu | 2016 | World Journal of Emergency Medicine2016，7，1： | 0 |
| 2 | Clinical predictors of abnormal chest CT scan findings following blunt chest trauma: A cross-sectional study显示文摘Purpose:Some surgeons believe that chest computed tomography(CT)scan should be used more prudently in management of blunt chest trauma patients.This study aimed to evaluate the clinical predictors of abnormal chest CT scan findings in trauma patients.Methods:This cross-sectional study was conducted on blunt chest trauma patients aged18 years who were referred to the emergency departments of two educational hospitals and underwent chest CT scan.These patients were enrolled in the study using a non-probability sampling method.The exclusion criteria included:class III or IV hemodynamic shock,need for immediate surgical or neurosurgical interventions,penetrating trauma,lack of required information,and pregnancy.Demographic factors,accident details,trauma mechanism,vital signs,and level of consciousness in predicting abnormal chest CT scan findings were evaluated.Analysis was performed using IBM SPSS statistics 21.Results:A total of 977 patients(male 51.5%,female 48.5%)with the mean age of(41.71±14.24)years,range 18e88 years were studied;34.2% of them with high energy trauma mechanism.With 334(34.2%)patients had abnormal findings on chest X-ray(CXR)and 332(34.0%)cases had an abnormal findings on chest CT scan(agreement rate was 99.4%).There was a significant correlation between male gender(p<0.0001),GCS<15(p<0.0001),high energy trauma mechanism(p<0.0001),unstable hemodynamics(p<0.01),and clinical signs and symptoms(p<0.0001)with chest CT findings.Chest wall deformity(odds=8;p<0.0001),generalized tenderness(odds=6.6,p<0.0001),and decreased cardiac sound(odds=3.8,p<0.0001)were the important and independent clinical predictors of abnormal chest CT scan findings.Conclusion:Based on the findings,chest wall deformity,generalized tenderness,decreased cardiac sound,distracting pain,chest wall tenderness,high energy trauma mechanism,male gender,respiratory rate>20 breathes/min,decreased pulmonary sound,and chest wall crepitation were independent clinical predictors of abnormal chest CT scan findings following blunt trauma. | Saeed Safari Melina Farbod Hamidreza Hatamabadi Mahmoud Yousefifard Navid Mokhtari | 2020 | Chinese Journal of Traumatology2020，23，1： | 0 |
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