Routine 6-Week Outpatient Radiography and Visit in Patients with Conservatively Treated Multiple Rib Fractures: Valuable or a Waste of Resources?
- Author:
Felix PEUKER
1
;
Thomas Philip BOSCH
;
Roderick Marijn HOUWERT
;
Ruben Joost HOEPELMAN
;
Menco Johannes Sophius NIEMEYER
;
Mark van BAAL
;
Fabrizio MINERVINI
;
Frank Johannes Paulus BEERES
;
Bryan Joost Marinus van de WALL
Author Information
- Publication Type:Clinical Research
- From: Journal of Chest Surgery 2024;57(5):430-439
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
