Routine 6-Week Outpatient Radiography and Visit in Patients with Conservatively Treated Multiple Rib Fractures : Valuable or a Waste of Resources?
Background: This study investigated the incidence and clinical consequences of abnormal radiological and clinical findings during routinely performed 6-week outpatient visits in patients treated conservatively for multiple (3 or more) rib fractures.
Methods: A retrospective analysis was conducted among patients with multiple rib fractures treated conservatively between 2018 and 2021 (Opvent database). The primary outcome was the incidence of abnormalities on chest X-ray (CXR) and their clinical consequences, which were categorized as requiring intervention or additional clinical/radiological examination. The secondary focus was the incidence of deviation from standard treatment in response to the findings (clinical or radiological) at the routine 6-week outpatient visit.
Results: In total, 364 patients were included, of whom 246 had a 6-week visit with CXR. The median age was 57 years (interquartile range, 46-70 years) and the median Injury Severity Score was 17 (interquartile range, 13-22). Forty-six abnormalities (18.7%) were found on CXR. These abnormalities resulted in additional outpatient visits in 4 patients (1.5%) and in chest drain insertion in 2 (0.8%). Only 2 patients (0.8%) with an abnormality on CXR presented without symptoms. None of the 118 patients who had visits without CXR experienced problems.
Conclusion: Routine 6-week outpatient visits for patients with conservatively treated multiple rib fractures infrequently revealed abnormalities requiring treatment modifications. It may be questioned whether the 6-week outpatient visit is even necessary. Instead, a more targeted approach could be adopted, providing follow-up to high-risk or high-demand patients only, or offering guidance on recognizing warning signs and providing aftercare through a smartphone application.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Journal of chest surgery - (2024) vom: 11. Apr. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Peuker, Felix [VerfasserIn] |
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| Links: |
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| Themen: |
Conservative treatment |
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| Anmerkungen: |
Date Revised 11.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.5090/jcs.23.134 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM37090138X |
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| 100 | 1 | |a Peuker, Felix |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Routine 6-Week Outpatient Radiography and Visit in Patients with Conservatively Treated Multiple Rib Fractures |b Valuable or a Waste of Resources? |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 11.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Background: This study investigated the incidence and clinical consequences of abnormal radiological and clinical findings during routinely performed 6-week outpatient visits in patients treated conservatively for multiple (3 or more) rib fractures | ||
| 520 | |a Methods: A retrospective analysis was conducted among patients with multiple rib fractures treated conservatively between 2018 and 2021 (Opvent database). The primary outcome was the incidence of abnormalities on chest X-ray (CXR) and their clinical consequences, which were categorized as requiring intervention or additional clinical/radiological examination. The secondary focus was the incidence of deviation from standard treatment in response to the findings (clinical or radiological) at the routine 6-week outpatient visit | ||
| 520 | |a Results: In total, 364 patients were included, of whom 246 had a 6-week visit with CXR. The median age was 57 years (interquartile range, 46-70 years) and the median Injury Severity Score was 17 (interquartile range, 13-22). Forty-six abnormalities (18.7%) were found on CXR. These abnormalities resulted in additional outpatient visits in 4 patients (1.5%) and in chest drain insertion in 2 (0.8%). Only 2 patients (0.8%) with an abnormality on CXR presented without symptoms. None of the 118 patients who had visits without CXR experienced problems | ||
| 520 | |a Conclusion: Routine 6-week outpatient visits for patients with conservatively treated multiple rib fractures infrequently revealed abnormalities requiring treatment modifications. It may be questioned whether the 6-week outpatient visit is even necessary. Instead, a more targeted approach could be adopted, providing follow-up to high-risk or high-demand patients only, or offering guidance on recognizing warning signs and providing aftercare through a smartphone application | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Conservative treatment | |
| 650 | 4 | |a Follow-up | |
| 650 | 4 | |a Multiple rib fractures | |
| 650 | 4 | |a Radiography | |
| 700 | 1 | |a Bosch, Thomas Philip |e verfasserin |4 aut | |
| 700 | 1 | |a Houwert, Roderick Marijn |e verfasserin |4 aut | |
| 700 | 1 | |a Hoepelman, Ruben Joost |e verfasserin |4 aut | |
| 700 | 1 | |a Niemeyer, Menco Johannes Sophius |e verfasserin |4 aut | |
| 700 | 1 | |a van Baal, Mark |e verfasserin |4 aut | |
| 700 | 1 | |a Minervini, Fabrizio |e verfasserin |4 aut | |
| 700 | 1 | |a Beeres, Frank Johannes Paulus |e verfasserin |4 aut | |
| 700 | 1 | |a van de Wall, Bryan Joost Marinus |e verfasserin |4 aut | |
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| 856 | 4 | 0 | |u http://dx.doi.org/10.5090/jcs.23.134 |3 Volltext |
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