Photo Credit: ALIOUI Mohammed Elamine

The following is a summary of “Risk factors for delayed hemothorax in patients with rib fracture in the emergency department,” published in the February 2024 issue of Emergency Medicine by Ahn, et al.

For a study, researchers sought to identify risk factors for delayed hemothorax development among patients presenting to the emergency department with rib fractures caused by blunt chest trauma.

The retrospective observational study included adult patients evaluated in the emergency room between January 2016 and February 2021. Patients with rib fractures who underwent chest tube insertion within 2 days or lacked follow-up chest radiographs within 2–30 days were excluded. A stepwise backward-elimination multivariable logistic regression model was utilized for analysis.

A total of 202 patients were analyzed. The number of total (P < 0.001), lateral (P = 0.019), and displaced (P < 0.001) rib fractures showed significant associations with delayed hemothorax. Additionally, lung contusions (P = 0.002), initial minimal hemothorax (P < 0.001), and pneumothorax (P < 0.001) were more frequently linked with delayed hemothorax. Age (adjusted odds ratio (aOR) 1.03, 95% CI 1.00–1.06, P = 0.022), mechanical ventilator use (aOR 9.67, 95% CI 1.01–92.75, P = 0.049), initial hemothorax (aOR 2.21, 95% CI 1.05–4.65, P = 0.037), initial pneumothorax (aOR 2.99, 95% CI 1.36–6.54, P = 0.006), and displaced rib fractures (aOR 3.51, 95% CI 1.64–7.53, P = 0.001) were independently associated with delayed hemothorax.

Age, mechanical ventilation, initial hemo- or pneumothorax, and displaced rib fractures emerged as independent risk factors for delayed hemothorax. Patients with these risk factors, particularly those with ≥2 displaced rib fractures, should undergo close chest radiography follow-up within 2–30 days post-injury.

Reference: sciencedirect.com/science/article/abs/pii/S0735675723006617