Chest Trauma Scoring Systems for Predicting Respiratory Complications in Isolated Rib Fracture
Junepill Seok1, Hyun Min Cho1, Ho Hyun Kim1
1Department of Trauma and Acute Care Surgery, Pusan National University Hospital, Busan, South Korea.
The Journal of Surgical Research
|July 8, 2019
Summary
The Thoracic Trauma Severity Score (TTSS) best predicts respiratory complications in isolated rib fractures with pulmonary contusion. However, the Rib Fracture Score (RFS) is more effective in patients without pulmonary contusion.
Area of Science:
- Trauma surgery
- Thoracic medicine
- Critical care
Background:
- Chest trauma scoring systems are used to predict respiratory complications in patients with rib fractures.
- Pulmonary contusion presence can influence the accuracy of these scoring systems.
Purpose of the Study:
- To compare the predictive accuracy of various chest trauma scoring systems for respiratory complications in isolated rib fractures.
- To evaluate the impact of pulmonary contusion on the performance of these scoring systems.
Main Methods:
- Retrospective analysis of 177 patients with isolated rib fractures.
- Evaluation of Abbreviated Injury Scale (AIS), Thoracic Trauma Severity Score (TTSS), Chest Trauma Score (CTS), Rib Fracture Score (RFS), and RibScore.
- Univariate and receiver operating characteristic (ROC) analyses were performed.
Main Results:
- The Thoracic Trauma Severity Score (TTSS) demonstrated the highest predictive accuracy (AUROC 0.723) across all patients.
- In patients with pulmonary contusion, TTSS remained the most accurate predictor (AUROC 0.704).
- In patients without pulmonary contusion, the Rib Fracture Score (RFS) showed the highest predictive accuracy (AUROC 0.759).
Conclusions:
- TTSS is the most effective scoring system for predicting respiratory complications in isolated rib fractures with pulmonary contusion.
- RFS is the most effective scoring system for predicting respiratory complications in isolated rib fractures without pulmonary contusion.
Related Concept Videos
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
605
Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
605
01:20The Thoracic Cage: Ribs
8.3K
Ribs are curved, flattened bones forming the thoracic cavity wall with the thoracic muscles. There are 12 pairs of thoracic ribs. The posterior ends of all the ribs articulate with the T1–T12 thoracic vertebrae. In contrast,the anterior ends of most ribs attach to the sternum via their costal cartilages.
Parts of a Typical Rib
A typical rib has a head, neck, and body. The posterior end of the rib is called the head, followed by a narrow neck. The head articulates primarily with the costal...
Parts of a Typical Rib
A typical rib has a head, neck, and body. The posterior end of the rib is called the head, followed by a narrow neck. The head articulates primarily with the costal...
8.3K
01:24Flail Chest-I
640
Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
640
01:26Flail Chest-II
559
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
559
01:24Chest Physiotherapy
1.7K
Chest Physiotherapy (CPT) is a therapeutic technique used in respiratory care to improve ventilation, clear bronchial secretions, and enhance the efficiency of respiratory muscles. This therapy includes three primary procedures: postural drainage, percussion, and vibration. It can be performed on spontaneously breathing patients and those who are intubated and mechanically ventilated.
Purpose
CPT is primarily used for patients with excessive bronchial secretions who have difficulty clearing...
Purpose
CPT is primarily used for patients with excessive bronchial secretions who have difficulty clearing...
1.7K
01:19Cyclic Processes And Isolated Systems
3.4K
A thermodynamic system with zero heat exchange and work is an isolated system. For these systems, the internal energy remains constant.
In the case of a non-isolated system, the change in the internal energy is zero only if the process is cyclic. A thermodynamic process is considered cyclic if the system undergoes a series of changes and returns to its initial state.
Consider a cyclic process that returns to its initial state, undergoing a four-step process. The heat transfer along each...
In the case of a non-isolated system, the change in the internal energy is zero only if the process is cyclic. A thermodynamic process is considered cyclic if the system undergoes a series of changes and returns to its initial state.
Consider a cyclic process that returns to its initial state, undergoing a four-step process. The heat transfer along each...
3.4K