Nalan Kozaci1, Mustafa Avcı2, Ertan Ararat3, Tansu Pinarbasili4, Muharrem Ozkaya5, Ibrahim Etli6, Eda Donertas1, Omer F Karakoyun1. 1. University of Health Sciences Antalya Education and Research Hospital, Department of Emergency Medicine, Antalya, Turkey. 2. University of Health Sciences Antalya Education and Research Hospital, Department of Emergency Medicine, Antalya, Turkey. Electronic address: dravcimustafa@gmail.com. 3. Usak University Education and Research Hospital, Department of Emergency Medicine, Usak, Turkey. 4. University of Health Sciences Antalya Education and Research Hospital, Department of Radiology, Antalya, Turkey. 5. University of Health Sciences Antalya Education and Research Hospital, Department of Thoracic Surgery, Antalya, Turkey. Electronic address: muharrem.ozkaya@sbu.edu.tr. 6. University of Health Sciences Antalya Education and Research Hospital, Department of Orthopedics and Traumatology, Antalya, Turkey.
Abstract
OBJECTIVE: In this study, the accuracy of bedside thoracic ultrasonography (TUSG) performed by emergency physicians with patients in the supine position was compared with that of thoracic computed tomography (TCT) for the determination of thoracic injuries due to trauma. METHODS: Patients who suffered the multiple traumas, whose thoracic trauma was identified on physical examination or TCT imaging were included in the study. TUSG was performed following a physical examination by the emergency physician who managed the trauma patient. Subcutaneous emphysema, pneumothorax, pulmonary contusions (PCs), hemothorax, pericardial effusion and tamponade, sternal and clavicular fractures and rib fractures were identified by TUSG. TCT imaging was performed after the ultrasonography examination was completed. RESULTS: Eighty-one patients were included in the study. TCT scans showed subcutaneous emphysema in 16 (19.8%) patients, pneumothorax in 21 (25.9%), PCs in 27 (33.3%), hemothorax in 20 (24.7%), sternum and clavicular fractures in 6 (7.4%) and rib fractures in 21 (25.9%). The sensitivity and specificity of ultrasonography varied for detecting the following pathologies: subcutaneous emphysema (56% and 95%), pneumothorax (86% and 97%), hemothorax (45% and 98%), PCs (63% and 91%), sternal fractures (83% and 97%), clavicular fractures (83% and 100%) and rib fractures (67% and 98%), respectively. CONCLUSION: In conclusion, ultrasound was found to be highly specific but only moderately sensitive for the identification of thoracic injuries.
OBJECTIVE: In this study, the accuracy of bedside thoracic ultrasonography (TUSG) performed by emergency physicians with patients in the supine position was compared with that of thoracic computed tomography (TCT) for the determination of thoracic injuries due to trauma. METHODS:Patients who suffered the multiple traumas, whose thoracic trauma was identified on physical examination or TCT imaging were included in the study. TUSG was performed following a physical examination by the emergency physician who managed the traumapatient. Subcutaneous emphysema, pneumothorax, pulmonary contusions (PCs), hemothorax, pericardial effusion and tamponade, sternal and clavicular fractures and rib fractures were identified by TUSG. TCT imaging was performed after the ultrasonography examination was completed. RESULTS: Eighty-one patients were included in the study. TCT scans showed subcutaneous emphysema in 16 (19.8%) patients, pneumothorax in 21 (25.9%), PCs in 27 (33.3%), hemothorax in 20 (24.7%), sternum and clavicular fractures in 6 (7.4%) and rib fractures in 21 (25.9%). The sensitivity and specificity of ultrasonography varied for detecting the following pathologies: subcutaneous emphysema (56% and 95%), pneumothorax (86% and 97%), hemothorax (45% and 98%), PCs (63% and 91%), sternal fractures (83% and 97%), clavicular fractures (83% and 100%) and rib fractures (67% and 98%), respectively. CONCLUSION: In conclusion, ultrasound was found to be highly specific but only moderately sensitive for the identification of thoracic injuries.
Authors: Dirk Stengel; Johannes Leisterer; Paula Ferrada; Axel Ekkernkamp; Sven Mutze; Alexander Hoenning Journal: Cochrane Database Syst Rev Date: 2018-12-12