Intercostal Muscle Density as a Prognostic Imaging Marker in Isolated Blunt Thoracic Trauma

Öz

Aim: To investigate the value of intercostal muscle density measured at the primary trauma site in predicting subsequent thoracic injuries, unexpected injuries, and poor clinical outcomes in patients with isolated blunt thoracic trauma, and to evaluate the relationship between muscle density and trauma characteristics, treatment modalities, and the follow-up process. Methods: This single-center, retrospectively designed study included 124 patients. The primary trauma site was determined by combined assessment of patient history, physical examination, and thoracic computed tomography (CT) findings. The density of the intercostal muscles corresponding to this site was measured and averaged. Results: Hounsfield unit (HU) values were significantly higher in patients with subsequent injury (n=14, 11.3%), unexpected injury (n=12, 9.7%), and poor outcome (n=30, 24.2%) (p=0.001, p=0.005, and p<0.001, respectively). HU value significantly predicted subsequent injuries (AUC=0.773, cutoff=56.0 HU, p=0.001), unexpected injuries (AUC=0.754, cutoff=56.0 HU, p=0.004), and poor outcome (AUC=0.746, cutoff=54.95 HU, p<0.001). On multivariate analysis, intercostal muscle density (OR=1.041, p<0.001) and number of rib fractures (OR=1.885, p<0.001) were identified as independent predictors of poor outcome. Age and sex were not significantly associated with poor outcome (p=0.767 and p=0.920, respectively). Conclusions: Intercostal muscle density measured at the primary trauma site, which can be obtained from routine thoracic CT without additional cost, may be a practical imaging parameter that helps predict subsequent and unexpected injuries as well as poor outcome, and may provide a complementary contribution to existing risk assessment methods.

Anahtar Kelimeler

• Thoracic Injuries
• Intercostal Muscles
• Tomography
• X-Ray Computed

Destekleyen Kurum

None.

Etik Beyan

The study was conducted at Kırıkkale Yüksek İhtisas Hospital in Türkiye. The Ethics Committee of Kırıkkale University approved the study protocol under decision number 2026.03.22. The study has been conducted in accordance with the World Medical Association Declaration of Helsinki.

Teşekkür

None.

İzole Künt Toraks Travmasında Prognostik Bir Görüntüleme Belirteci Olarak İnterkostal Kas Yoğunluğu

Öz

Amaç: İzole künt toraks travması olan hastalarda, primer travma bölgesinden ölçülen interkostal kas dansitesinin sonradan gelişen toraks yaralanmalarını, beklenmedik yaralanmaları ve kötü klinik sonlanımları öngörmedeki değerini araştırmak; ayrıca kas dansitesi ile travma, tedavi yöntemleri ve takip süreci arasındaki ilişkiyi değerlendirmek. Yöntemler: Tek merkezli, retrospektif olarak tasarlanan bu çalışmaya 124 hasta dahil edildi. Primer travma bölgesi hasta beyanı, fizik muayene ve toraks bilgisayarlı tomografi (CT) bulguları birlikte değerlendirilerek belirlendi. Bu bölgeye karşılık gelen interkostal kasların dansitesi ölçülerek ortalamaları alındı. Bulgular: Sonradan gelişen yaralanması (n=14, %11.3), beklenmedik yaralanması (n=12, %9.7) ve kötü sonlanımı olan hastalarda (n=30, %24.2) Hounsfield Unit (HU) değerleri anlamlı olarak daha yüksekti(sırasıyla p=0.001, p=0.005 ve p<0.001). HU değeri sonradan gelişen yaralanmaları (AUC=0.773, eşik=56.0 HU, p=0.001), beklenmedik yaralanmaları (AUC=0.754, eşik=56.0 HU, p=0.004) ve kötü sonlanımı (AUC=0.746, eşik=54.95 HU, p<0.001) anlamlı düzeyde öngördü. Çok değişkenli analizde interkostal kas dansitesi (OR=1.041, p<0.001) ve kot fraktürü sayısı (OR=1.885, p<0.001), kötü sonlanımın birbirinden bağımsız belirleyicileri olarak saptandı. Yaş ve cinsiyet ile kötü sonlanım arasında anlamlı ilişki bulunmadı (sırasıyla p=0.767 ve p=0.920). Sonuçlar: Primer travma bölgesinden ölçülen interkostal kas dansitesi, ek maliyet gerektirmeden rutin toraks CT'den elde edilebilen, sonradan gelişen ve beklenmedik yaralanmalar ile kötü sonlanımı öngörmede yardımcı olabilecek pratik bir görüntüleme parametresi olabilir ve mevcut risk değerlendirme yöntemlerine tamamlayıcı katkı sağlayabilir.

Anahtar Kelimeler

• Torasik yaralanmalar
• İnterkostal kaslar
• Bilgisayarlı tomografi

Destekleyen Kurum

Yok.

Etik Beyan

Çalışma, Türkiye'deki Kırıkkale Yüksek İhtisas Hastanesi'nde gerçekleştirilmiştir. Çalışma protokolü, Kırıkkale Üniversitesi Etik Kurulu tarafından 2026.03.22 karar numarasıyla onaylanmıştır. Çalışma, Dünya Tabipler Birliği Helsinki Bildirgesi'ne uygun olarak yürütülmüştür.

Teşekkür

Yok.

Kaynakça

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