Department of Thoracic Surgery, Izmir Democracy University Buca Seyfi Demirsoy Education and Research Hospital, Izmir, Turkey.
Department of Thoracic Surgery, Health Sciences University Dr. Suat Seren Chest Diseases and Chest Surgery Education and Research Hospital, Izmir, Turkey.
Sci Rep. 2024 Nov 30;14(1):29827. doi: 10.1038/s41598-024-79548-z.
The precise assessment of hemothorax risk resulting from a rib fracture is not feasible. CT images, patient characteristics, and clinical experience are utilized in daily practice to assess risk intuitively. This study aimed to identify specific markers on CT images that can predict the risk of hemothorax. The study was retrospectively conducted between May 2021 and December 2023 at three different centers. Patients diagnosed with hemothorax at the initial assessment or during follow-up were identified among those being followed for rib fractures. An investigation was carried out to examine the relationship between the number of rib fractures, displacement status, and the location of the fracture on the rib arch with the risk of hemothorax. Of the 273 patients included in the study, 201 (73.6%) were male. The mean age was 53.9 ± 17.27 (19-93) years. Lateral (p = 0.029) and posterior (p < 0.001) location of the fracture and displacement of at least one fracture (p = 0.003) were associated with an increased risk. There was a significant correlation between the number of rib fractures and the risk of hemothorax (p < 0.001). The optimal cut-off for the number of rib fractures associated with a high risk of hemothorax was determined to be 4. Anatomical characteristics of a rib fracture can be useful to assess the risk of hemothorax practically in patients with thoracic trauma especially in emergency rooms. Patients with four or more rib fractures, at least one displaced rib fracture, and lateral and posterior rib fractures should be followed more carefully for hemothorax.
对于肋骨骨折导致的血胸风险进行精确评估是不可行的。在日常实践中，医生会结合 CT 图像、患者特征和临床经验进行直观评估。本研究旨在确定 CT 图像上的特定标记物，以预测血胸风险。本研究于 2021 年 5 月至 2023 年 12 月在三个不同中心进行，回顾性分析了因肋骨骨折而接受随访的患者中初次评估或随访期间发生血胸的患者。研究旨在探讨肋骨骨折数量、移位状态和肋骨弓上骨折位置与血胸风险之间的关系。本研究共纳入 273 例患者，其中 201 例（73.6%）为男性，平均年龄为 53.9±17.27 岁（19-93 岁）。骨折的外侧（p=0.029）和后侧（p<0.001）位置以及至少一处骨折的移位（p=0.003）与风险增加相关。肋骨骨折数量与血胸风险之间存在显著相关性（p<0.001）。与血胸风险高相关的肋骨骨折数量的最佳截断值被确定为 4。肋骨骨折的解剖特征可用于评估胸外伤患者的血胸风险，尤其是在急诊室。对于存在 4 处或以上肋骨骨折、至少一处移位肋骨骨折以及外侧和后侧肋骨骨折的患者，应更加密切地观察其血胸情况。
