Dataset Information

Clinical prediction rule for delayed hemothorax after minor thoracic injury: a multicentre derivation and validation study.

ABSTRACT:

Background

About 75% of patients with minor thoracic injury are discharged after an emergency department visit. However, complications such as delayed hemothorax can occur. We sought to derive and validate a clinical decision rule to predict hemothorax in patients discharged from the emergency department.

Methods

We conducted a 6-year prospective cohort study in 4 university-affiliated emergency departments. Patients aged 16 years or older presenting with a minor thoracic injury were assessed at 5 time points (initial visit and 7, 14, 30 and 90 d after the injury). Radiologists' reports were reviewed for the presence of hemothorax. We used log-binomial regression models to identify predictors of hemothorax.

Results

A total of 1382 patients were included: 830 in the derivation phase and 552 in the validation phase. Of these, 151 (10.9%) had hemothorax at the 14-day follow-up. Patients 65 years of age or older represented 25.3% (210/830) and 23.7% (131/552) of the derivation and validation cohorts, respectively. The final clinical decision rule included a combination of age (> 70 yr, 2 points; 45-70 yr, 1 point), fracture of any high to mid thorax rib (ribs 3-9, 2 points) and presence of 3 or more rib fractures (1 point). Twenty (30.8%) of the 65 high-risk patients (score ? 4) experienced hemothorax during the follow-up period. The clinical decision rule had a high specificity (90.7%, 95% confidence interval 87.7%-93.1%) in this high-risk group, thus guiding appropriate post-emergency care.

Interpretation

One patient out of every 10 presented with delayed hemothorax after discharge from the emergency department. Implementation of this validated clinical decision rule for minor thoracic injury could guide emergency discharge plans.

SUBMITTER: Emond M

PROVIDER: S-EPMC5498437 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Publications

Clinical prediction rule for delayed hemothorax after minor thoracic injury: a multicentre derivation and validation study.

Émond Marcel M Guimont Chantal C Chauny Jean-Marc JM Daoust Raoul R Bergeron Éric É Vanier Laurent L Moore Lynne L Plourde Miville M Kuimi Batomen B Boucher Valérie V Allain-Boulé Nadine N Le Sage Natalie N

CMAJ open 20170601 2

<h4>Background</h4>About 75% of patients with minor thoracic injury are discharged after an emergency department visit. However, complications such as delayed hemothorax can occur. We sought to derive and validate a clinical decision rule to predict hemothorax in patients discharged from the emergency department.<h4>Methods</h4>We conducted a 6-year prospective cohort study in 4 university-affiliated emergency departments. Patients aged 16 years or older presenting with a minor thoracic injury w ...[more]

PMID: 28611156

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Dataset Information

Clinical prediction rule for delayed hemothorax after minor thoracic injury: a multicentre derivation and validation study.

Background

Methods

Results

Interpretation

Publications

Clinical prediction rule for delayed hemothorax after minor thoracic injury: a multicentre derivation and validation study.

Similar Datasets

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