Blunt Minor Thoracic Trauma: A Prospective Analysis of 186 Patients in the Emergency Department

Year 2017, , 203 - 208, 01.12.2017

Faruk Güngör Kamil Can Akyol Taylan Kılıç Mustafa Keşaplı Asım Arı Ali Vefa Sayraç

https://doi.org/10.5505/kjms.2017.60352

Abstract

Aim: There is limited information regarding patients with blunt
minor thoracic traumas (MTT) in terms of diagnosis, treatment,
emergency department (ED) management and follow-up after discharge.
The aim of this research, was to investigate demographics,
physical examination findings and their predictive value for concomitant
thoracic injuries, and outcomes of patients.
Material and Method: The mechanism of injury, physical examination
findings, radiographic findings, pain levels, discharge and
hospitalization diagnoses were recorded prospectively.
Results: A total of 186 patients with a mean age of 48±17 (18–
91) years were included in the study. 131 of the (70.4%) patients
were males. 171 of the patients (91.9%) were discharged, while 15
(8.1%) patients were hospitalized. The most common diagnosis
and physical finding were soft tissue trauma, and tenderness at
injury site (78.8%, 15.1%, 69.6%), respectively. The specificity of
physical findings in predicting concomitant thoracic injuries were
found to be 100%, although their sensitivities were too low. The
initial and 7th day pain levels of the patients with recurrent admissions
were significantly higher (p=0.019, p=0.025).
Conclusion: Most patients are discharged from ED without significant
morbidity and mortality. Patients exhibiting the positive physical
findings require detailed investigation for concomitant thoracic
injuries. As severe and long-lasting pains are determinants of hospital
re-admissions, it would be appropriate to provide adequate
analgesia and detailed information about the pain.

Keywords

minor blunt thoracic trauma, physical examination, pain and analgesia

Künt Minör Toraks Travması: Acil Servise Başvuran 186 Hastanın Prospektif Analizi

Abstract

Amaç: Künt minör toraks travmalı (MTT) hastalarda tanı, tedavi, acil servis (AS) yönetimi ve taburculuk sonrası takip bakımından
bilgiler kısıtlıdır. Hastaların demografik verilerini, fizik muayene bulgularını ve bu bulguların eşlik eden torasik yaralanmaları ön
görmedeki değerliklerini, hastaların sonlanımlarını araştırması amaçlandı.
Materyal ve Metot: Yaralanma mekanizması, fizik muayene bulguları, görüntüleme bulguları, ağrı düzeyleri, taburculuk ve hastaneye
yatış tanıları prospektif olarak çalışma formuna kaydedildi. 
Bulgular: Çalışmaya, alınan 186 hastanın yaş ortalaması 48±17 (18–91) 131’i (%70,4) erkekti. Hastaların 171’i (%91,9) acil servisten taburcu edilirken, 15’i (%8,1) hastaneye yatırıldı. En sık tanı, yumuşak doku travması (%78,8) ve en sık muayene bulgusu yaralanma yerinde duyarlılıktı (%69,6). Duyarlılıkları çok düşük olsa da fizik muayene bulguları eşlik eden torasik yaralanmaları saptamadaki özgüllükleri %100 bulundu. Tekrarlayan başvurusu olan hastaların başlangıç ve 7. gündeki ağrı düzeyleri istatistiki olarak daha yüksek saptandı (p=0,019, p=0,025).
Sonuç: MTT’lı çoğu hasta, önemli bir morbidite ve mortalite olmadan AS’den taburcu edilmektedir. Pozitif fizik muayene bulguları
bulunan hastalar, eşlik eden torasik yaralanmalar açısından detaylı araştırılmalıdır. Ciddi ve uzun süren ağrı tekrar başvuruların belirleyicileri olduğundan yeterli analjezik tedavi sağlanarak ağrı konusunda hastalar detaylı bilgilendirmelidir.

Keywords

minör künt toraks travması, fizik muayene, ağrı ve analjezi

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