Journal of Chest Surgery

  • 제57권5호
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  • Pages.430-439
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  • 2024
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
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Routine 6-Week Outpatient Radiography and Visit in Patients with Conservatively Treated Multiple Rib Fractures: Valuable or a Waste of Resources?

  • Felix Peuker (Department of Trauma Surgery, University Medical Center Utrecht) ;
  • Thomas Philip Bosch (Department of Orthopedic and Trauma Surgery, Cantonal Hospital Lucerne) ;
  • Roderick Marijn Houwert (Department of Trauma Surgery, University Medical Center Utrecht) ;
  • Ruben Joost Hoepelman (Department of Trauma Surgery, University Medical Center Utrecht) ;
  • Menco Johannes Sophius Niemeyer (Department of Trauma Surgery, University Medical Center Utrecht) ;
  • Mark van Baal (Department of Trauma Surgery, University Medical Center Utrecht) ;
  • Fabrizio Minervini (Department of Thoracic Surgery, Cantonal Hospital Lucerne) ;
  • Frank Johannes Paulus Beeres (Department of Orthopedic and Trauma Surgery, Cantonal Hospital Lucerne) ;
  • Bryan Joost Marinus van de Wall (Department of Orthopedic and Trauma Surgery, Cantonal Hospital Lucerne)
  • 투고 : 2023.09.25
  • 심사 : 2024.02.05
  • 발행 : 2024.09.05
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초록

Background: This study investigated the incidence and clinical consequences of abnormal radiological and clinical findings during routinely performed 6-week outpatient visits in patients treated conservatively for multiple (3 or more) rib fractures. Methods: A retrospective analysis was conducted among patients with multiple rib fractures treated conservatively between 2018 and 2021 (Opvent database). The primary outcome was the incidence of abnormalities on chest X-ray (CXR) and their clinical consequences, which were categorized as requiring intervention or additional clinical/radiological examination. The secondary focus was the incidence of deviation from standard treatment in response to the findings (clinical or radiological) at the routine 6-week outpatient visit. Results: In total, 364 patients were included, of whom 246 had a 6-week visit with CXR. The median age was 57 years (interquartile range, 46-70 years) and the median Injury Severity Score was 17 (interquartile range, 13-22). Forty-six abnormalities (18.7%) were found on CXR. These abnormalities resulted in additional outpatient visits in 4 patients (1.5%) and in chest drain insertion in 2 (0.8%). Only 2 patients (0.8%) with an abnormality on CXR presented without symptoms. None of the 118 patients who had visits without CXR experienced problems. Conclusion: Routine 6-week outpatient visits for patients with conservatively treated multiple rib fractures infrequently revealed abnormalities requiring treatment modifications. It may be questioned whether the 6-week outpatient visit is even necessary. Instead, a more targeted approach could be adopted, providing follow-up to high-risk or high-demand patients only, or offering guidance on recognizing warning signs and providing aftercare through a smartphone application.

키워드

과제정보

This work was part of the activities of the Natural Experiments Study Group (www.next-studygroup.org).

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