Related Experiment Video
Updated: Mar 8, 2026
Focused Assessment with Sonography for Trauma FAST Exam: Image Acquisition
Published on: September 22, 2023
Forced vital capacity assessment for risk stratification of blunt chest trauma patients in emergency settings: A
Cédric Carrie1, Laurent Stecken2, Marion Scotto1
1Anesthesiology and Critical Care Department I, CHU Bordeaux, 33000 Bordeaux, France.
Insights
Forced Vital Capacity (FVC) measured at emergency discharge effectively predicts secondary respiratory complications in blunt chest trauma patients. An FVC of 50% or less at discharge indicates a higher risk, preventing under-triage.
Area of Science:
- Pulmonology
- Trauma Surgery
- Critical Care Medicine
Background:
- Blunt chest trauma frequently leads to secondary respiratory complications.
- Early identification of patients at risk is crucial for effective management.
- Current assessment methods may not fully capture post-injury respiratory compromise.
Purpose of the Study:
- To evaluate the predictive performance of Forced Vital Capacity (FVC) for secondary respiratory complications in blunt chest trauma patients.
- To determine if FVC measurements at admission or discharge are better predictors.
- To establish a threshold for FVC that indicates increased risk.
Main Methods:
- Prospective study of 62 consecutive blunt chest trauma patients with >3 rib fractures.
- Forced Vital Capacity (FVC) measured at emergency intensive care unit admission and discharge.
- Secondary respiratory complications defined as pulmonary infection, ICU readmission, mechanical ventilation, or death.
- Receiver operating characteristic (ROC) curve and logistic regression analyses used.
Main Results:
- 13% of patients developed secondary respiratory complications.
- FVC at emergency discharge, not at admission, was significantly lower in patients with complications (44% vs. 61%, P=0.002).
- An FVC discharge of ≤50% was independently associated with complications (OR 7.9, P=0.004), with an ROC AUC of 0.79.
Conclusions:
- Non-improvement of FVC to >50% at emergency discharge predicts secondary respiratory complications.
- This finding can help prevent under-triage of at-risk patients.
- FVC measurement at discharge is a valuable tool for risk stratification in blunt chest trauma.
Objective:
The aim of this study was to assess the performance of Forced Vital Capacity (FVC) for prediction of secondary respiratory complications in blunt chest trauma patients.
Methods:
During a 15-month period, all consecutive blunt chest trauma patients admitted in our emergency intensive care unit with more than 3 rib fractures were eligible, unless they required mechanical ventilation in the prehospital or emergency settings. FVC was measured at admission and at emergency discharge after therapeutic interventions. The main outcome was the occurrence of secondary respiratory complications defined by hospital-acquired pulmonary infection, secondary admission in the intensive care unit or mechanical ventilation for respiratory failure or death. The performance of FVC for prediction of secondary respiratory complications was assessed by receiver operating characteristic (ROC) curve and multivariate analysis after logistic regression.
Results:
Sixty-two consecutive patients were included and 13 (21%) presented secondary respiratory complications. Only FVC measured at emergency discharge - not FCV at admission - was significantly lower in patients who developed secondary respiratory complications (44±15 vs. 61±20%, P=0.002). The area under the ROC curves for FCV in predicting secondary pulmonary complications was 0.79 [95% CI: 0.66-0.88], P=0.0001. An FVC at discharge≤50% was independently associated with the occurrence of secondary complications with an OR at 7.9 [1.9-42.1], P=0.004.
Conclusion:
The non-improvement of FVC≤50% at emergency discharge is associated with secondary respiratory complications and should prevent the under-triage of patients with no sign of respiratory failure at admission.
