Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2020
Performance of pre-hospital evaluations in ruling out invasive chest stab wounds.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 8 citations in OpenAlex.
- Diagnostic accuracy of clinical examination to identify life- and limb-threatening injuries in trauma patients.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Article
- Complications associated with pre-hospital open thoracostomies: a rapid review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Review
- The contribution of helicopter emergency medical services in the pre-hospital care of penetrating torso injuries in a semi-rural setting.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSome guidelines advocate for managing patients with penetrating thoracic wounds in trauma centres with cardiothoracic surgery. This systematic approach is questionable. Only 15% of these patients require surgery. It is known that clinical examination fails to detect hemopneumothorax in penetrating trauma. However, no studies have evaluated the combined diagnostic performance of vital signs and the clinical evaluation of wounds. The clinical characteristics of wounds have not been investigated. We aimed to evaluate the ability of combinations of pre-hospital signs to rule out invasive chest stab trauma.
methodsThis was a prospective observational study. All consecutive adult patients hospitalized in the perioperative acute care unit of a tertiary university hospital were included. Injury diagnoses were provided by exploratory surgery and imaging tests. Patients with a final diagnosis of invasive wounds (IWs) and patients with only superficial wounds were compared. Data regarding management and outcome were analysed.
resultsA total of 153 patients were included. After imaging or surgery, 58 (38%) patients were diagnosed with only superficial wounds, and 95 (62%) were diagnosed with thoracic or abdominal IWs. The false-negative rate of pre-hospital evaluations in the diagnosis of IWs was 42% [31-51]
conclusionsThe combination of pre-hospital vital signs, visual evaluation of wounds, and physical examination failed to rule out IWs in patients with chest stab wounds. This implies that caution is needed in triage decision-making.
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