Huang P, Fong C, Rademaker A
Department of Emergency Medicine, Foothills Hospital, Calgary, Alberta, Canada.
Ann Emerg Med. 1987 Dec;16(12):1330-3. doi: 10.1016/s0196-0644(87)80413-4.
We reviewed initial chest radiographs of 21 patients with, and 26 without, aortic rupture, and examined the presence or absence of individual signs previously cited to be associated with aortic rupture. Using stepwise logistic regression, the three most significant signs associated with rupture were loss of aortic contour, tracheal deviation, and mediastinal-to-chest ratio. A formula calculating the probability of aortic rupture (P) using these three variables was derived. Using a low cutoff point, this equation would approach 100% sensitivity in detecting aortic rupture while reducing the number of negative aortographs. The reliability of this equation and the optimal cutoff point must be determined in a prospective study before being used to make clinical decisions.
我们回顾了21例发生主动脉破裂和26例未发生主动脉破裂患者的初始胸部X线片，并检查了先前引用的与主动脉破裂相关的各个体征的有无。使用逐步逻辑回归分析，与破裂相关的三个最显著体征为主动脉轮廓消失、气管移位和纵隔与胸部比值。由此得出了一个使用这三个变量计算主动脉破裂概率（P）的公式。采用较低的截断点，该方程在检测主动脉破裂时灵敏度将接近100%，同时减少主动脉造影阴性的数量。在用于临床决策之前，必须在前瞻性研究中确定该方程的可靠性和最佳截断点。
