Thoracic Spine Fracture in the Panscan Era
| Autor: | William R. Mower, Gregory W. Hendey, Brigitte M. Baumann, Robert M. Rodriguez, Sergio Alvarez, Anthony J. Medak, Daniel K. Nishijima, Remy Bizimungu, Ali S. Raja, Mark I. Langdorf |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Thoracic Radiography Wounds Nonpenetrating Injury Severity Score 0302 clinical medicine Medicine 030212 general & internal medicine Tomography Lumbar Vertebrae medicine.diagnostic_test Accidents Traffic Injuries and accidents Middle Aged X-Ray Computed Scapula Hospitalization Motorcycles Blunt trauma Wounds Cervical Vertebrae Emergency Medicine Spinal Fractures Radiography Thoracic Female Presentation (obstetrics) musculoskeletal diseases Adult medicine.medical_specialty Physical Injury - Accidents and Adverse Effects Rib Fractures Thoracic Injuries Clinical Sciences Thoracic Vertebrae 03 medical and health sciences Clinical Research Humans Nonpenetrating Traffic Mortality Aged Pedestrians Hemothorax Multiple Trauma business.industry Neurosciences 030208 emergency & critical care medicine Emergency department Length of Stay Thoracic spine fracture Clavicle Emergency & Critical Care Medicine Confidence interval Surgery Good Health and Well Being Accidents Injury (total) Accidents/Adverse Effects Accidental Falls Tomography X-Ray Computed business Chest radiograph |
| Zdroj: | Annals of emergency medicine, vol 76, iss 2 |
| ISSN: | 0196-0644 |
| Popis: | STUDY OBJECTIVE:In the current era of frequent chest computed tomography (CT) for adult blunt trauma evaluation, many minor injuries are diagnosed, potentially rendering traditional teachings obsolete. We seek to update teachings in regard to thoracic spine fracture by determining how often such fractures are observed on CT only (ie, not visualized on preceding trauma chest radiograph), the admission rate, mortality, and hospital length of stay of thoracic spine fracture patients, and how often thoracic spine fractures are clinically significant. METHODS:This was a preplanned analysis of prospectively collected data from the NEXUS Chest CT study conducted from 2011 to 2014 at 9 Level I trauma centers. The inclusion criteria were older than 14 years, blunt trauma occurring within 6 hours of emergency department (ED) presentation, and chest imaging (radiography, CT, or both) during ED evaluation. RESULTS:Of 11,477 enrolled subjects, 217 (1.9%) had a thoracic spine fracture; 181 of the 198 thoracic spine fracture patients (91.4%) who had both chest radiograph and CT had their thoracic spine fracture observed on CT only. Half of patients (49.8%) had more than 1 level of thoracic spine fracture, with a mean of 2.1 levels (SD 1.6 levels) of thoracic spine involved. Most patients (62%) had associated thoracic injuries. Compared with patients without thoracic spine fracture, those with it had higher admission rates (88.5% versus 47.2%; difference 41.3%; 95% confidence interval 36.3% to 45%), higher mortality (6.3% versus 4.0%; difference 2.3%; 95% confidence interval 0 to 6.7%), and longer length of stay (median 9 versus 6 days; difference 3 days; P |
| Databáze: | OpenAIRE |
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