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Étude de cohorte sur la prévalence et les facteurs de risque de complications pulmonaires tardives chez les adultes à la suite d'un traumatisme thoracique mineur fermé. / [Cohort study on the prevalence and risk factors of late pulmonary complications in adults following a closed minor chest trauma].

Plourde, Miville; Émond, Marcel; Lavoie, André; Guimont, Chantal; Le Sage, Natalie; Chauny, Jean-Marc; Bergeron, Éric; Vanier, Laurent; Moore, Lynne; Allain-Boulé, Nadine; Fratu, Ramona-Florina; Dufresne, Maryline.
CJEM ; 15(6): 337-44, 2013 Nov.
Artículo en Francés | MEDLINE | ID: mdl-24176457

OBJECTIVES:

The objectives of this study are to determine the prevalence, risk factors, and time to onset of delayed hemothorax and pneumothorax in adults who experienced a minor blunt thoracic trauma.

METHOD:

A prospective cohort of 450 consecutive patients was recruited. Eligible patients had to be over 16 years of age, consulted within 72 hours for a trauma, and available for outpatient follow-up at 2, 7, and 14 days posttrauma. The clinical outcome investigated was the presence of delayed pneumothorax or hemothorax on the follow-up chest x-ray.

OUTCOMES:

Delayed hemothorax occurred in 11.8% (95% CI 8.8-14.8), and delayed pneumothorax occurred in 0.9% (95% CI 0.2-2.3) of participants. During the 14-day follow-up period, 87.0% of these delayed complications developed in the first week. In the multivariate analysis, the only statistically significant risk factor for delayed complications was the location of fractures on the x-ray of the hemithorax. The adjusted odds ratio was 1.52 (95% CI 0.62-3.73) for the lower ribs (tenth to twelfth rib), 3.11 (95% CI 1.60-6.08) for the midline ribs (sixth to ninth rib), and 5.05 (95% CI 1.80-14.19) for the upper ribs (third to fifth rib) versus patients with no fractures.

CONCLUSION:

The presence of at least one rib fracture between the third and ninth rib on the x-ray of the hemithorax is a significant risk factor for delayed hemothorax and pneumothorax.