What is the relationship between the Number of Significant rib fractures and Haemothorax in adults with blunt chest trauma?
Main Article Content
Keywords
Chest Tube, Haemothorax, Intercostal vessels, Relationship, Rib fracture
Abstract
Background: The study aimed to determine the correlation between the number of significant rib fractures in patients with blunt chest trauma (BCT) and the amount of haemothorax as recorded by Closed Thoracostomy Tube Drainage (CTTD).
Methodology: This was a cross-sectional study of all patients with significant rib fractures following BCT over a period of two years. “Significant rib fractures” was defined as the fracture of 3 or more ribs with 50% or more displacement of each fractured rib edge. Patients with massive haemothorax, patients with severe neurological, or patients who required emergency thoracotomy were excluded. The diagnosis of rib fracture was made by standard chest radiograph or Chest Tomography Scan. Descriptive analyses were reported as mean and standard deviation (SD) for the variables. Pearson correlation test was conducted to test the relationship between the numbers of fractured ribs with the amount of haemothorax as recorded by CTTD with P-value significant at<0.001.
Result: Sixteen patients who met the criteria were analysed with a mean age of 46.5years+(SD16.47), the mean number of fractured ribs was 4.5+1.37, the mean amount of drained blood was 605.3ml+(SD244.3) and the mean amount of drained blood per the number of each fractured rib was 134.5ml+54.29. The Pearson Correlation test was strongly positive at,r=0.80 with (P < 0.001).
Conclusion: In any patient with BCT, and with fractured of 3 or more ribs, there may be the need to institute a CTTD irrespective of whether the chest radiograph or chest computerized scan shows immediate evidence of significant haemothorax.
References
2. Okonta KE, Ocheli EO, Okoh PD, Ekwunife CN. Traumatic Rib Fracture: Important contributors to morbidity and mortality. Niger J Cardiovasc Thoracic Surg.2019;4:29-22
3.Feliciano DV. The diagnostic and therapeutic approach to chest trauma. In: Loop FD, McLaughlin JS, eds. Semin Thorac Cardiovasc Surg 1992;4:156-62.
4.Sinha P, Sarkar P. Late clotted haemothorax after blunt chest trauma.J Accid Emerg Med.1998;15(3):189-191.
5.Chien CY, Chen YH, Han ST, Blaney GN, Huang T, Chen K. The number of displaced fractures is more predictive for complication in chest trauma patients. Scand J Trauma . Resusc Emerg Med .2017;25:19.
6.Bemelman M,de Kruif MW,Baal Mv,Leenen L.Rib Fractures: To Fix or Not to Fix? An Evidence-Based Algorithm. Korean J Thorac Cardiovasc Surg. 2017; 50(4): 229–234.
7. LewisMI,McKenna RJ. Medical management of the thoracic surgery patients. ISBN: 978-1-4160-3993-8 Copyright © 2010 by Saunders, an imprint of Elsevier Inc.Rakovich G,Frechette E,Deslauriers J. Chapter 8 - Thoracic Surgical Anatomy and Procedures.
8. Broderick SR. Hemothorax: Etiology, diagnosis, and management. Thorac Surg Clin. 2013; 23(1):89-96.
9. Eren S, Esme H, Sehitogullari A, Durkan A. The risk factors and management of posttraumatic empyema in trauma patients. Injury. 2008;39(1):44‐49.
10. Hoth JJ, Burch PT, Bullock TK, Cheadle WG, Richardson JD. Pathogenesis of posttraumatic empyema: the impact of pneumonia on pleural space infections. Surg Infect (Larchmt). 2003;4(1):29‐35.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access journal and articles are distributed under the terms of the Creative Commons Attribution Non-Commercial Share-Alike License 4.0. This licence allows users to download and share, remix, tweak and build upon the article for non-commercial purposes, so long as the original authorship is acknowledged and the new creations are licensed under identical terms.