• Annals of surgery · Dec 2015

    Observational Study

    Functional Impact of a Minor Thoracic Injury: An Investigation of Age, Delayed Hemothorax, and Rib Fracture Effects.

    • Marcel Émond, Marie-Josée Sirois, Chantal Guimont, Jean-Marc Chauny, Raoul Daoust, Éric Bergeron, Laurent Vanier, Stephanie Camden, and Natalie Le Sage.
    • *Unité de Recherche en Traumatologie - Urgence - Soins Intensifs, Axe de Recherche en Santé des Populations et Pratique Optimale des Soins, Centre de Recherche FRQ-S du Centre Hospitalier Universitaire de Québec, Québec, Canada †Département de Médecine Familiale et de Médecine D'Urgence, Université Laval, Québec, Canada ‡Département de Réadaptation, Université Laval, Québec, Canada §Centre Hospitalier du Sacré-Cœur de Montréal, Canada ¶Centre hospitalier de Charles-LeMoyne, Greenfield Park, Québec, Canada.
    • Ann. Surg. 2015 Dec 1;262(6):1115-22.

    ObjectiveTo investigate whether minor thoracic injuries (MTIs) relate to subsequent functional limitations.BackgroundApproximately 75% of patients with an MTI are discharged after an emergency department (ED) visit, whereas significant functional limitations can occur in the weeks that follow.MethodsA 19 months' prospective cohort study with a 90-day follow-up was conducted at 4 university-affiliated EDs. Patients 16 years and older with an MTI were assessed at initial ED visit, 7, 14, 30, and 90 days after injury. Functional outcome was measured using the SF-12 scale. General linear model were used to assess outcome.ResultsA total of 482 patients were included, of whom 127 (26.3%) were 65 or older. Overall, 147 patients (30.5%) presented with at least 1 rib fracture and 59 subjects (12.2%) with delayed hemothorax. At 90 days, 22.8% of patients still had severe or moderate disabilities on global physical health score. Patients with solely delayed hemothorax and no rib fracture had the lowest global physical health score (46.4 vs 61.1, P < 0.01, effect size =  -2.60) than patients with simple MTI. Generally, functional limitations also increase with increments of number of rib fracture detected on radiograph. Outcomes were not different among patients 65 years or older when compared to their younger counterparts.ConclusionsIn this prospective study of MTIs, severe to moderate disabilities were present in nearly 1 patient out of 5 at 90 days. The presence of delayed hemothorax and the number of rib fracture were associated with increased functional limitations after a MTI.

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