Accuracy of auscultation in the detection of haemopneumothorax.

OBJECTIVE

To assess the accuracy of auscultation in the detection of haemopneumothorax.

DESIGN

Prospective study.

SETTING

University hospital, Taiwan.

PATIENTS

148 patients with chest injuries admitted between July 1994 and August 1996.

MAIN OUTCOME MEASURES

Correlation between the results of auscultation and radiographic findings in 148 patients with injuries to the chest. 83 (56%) had internal injuries, of whom 38 had pneumothoraces, 24 haemothoraces, and 21 haemopneumothoraces.

RESULTS

Auscultation had a sensitivity of 84%, a specificity of 97%, an accuracy of 89% and a positive predictive value of 97% in the detection of these injuries.

CONCLUSIONS

Auscultation is not as accurate as chest radiography. Chest tubes can be inserted before chest radiography in patients in whom auscultation has indicated an injury. A chest radiograph is essential in those patients with normal breath sounds to exclude a haemopneumothorax that had been missed by auscultation.