Clinical prediction rule for delayed hemothorax after minor thoracic injury: a multicentre derivation and validation study.

Clinical prediction rule for delayed hemothorax after minor thoracic injury: a multicentre derivation and validation study. CMAJ Open. 2017 Jun 12;5(2):E444-E453 Authors: Émond M, Guimont C, Chauny JM, Daoust R, Bergeron É, Vanier L, Moore L, Plourde M, Kuimi B, Boucher V, Allain-Boulé N, Le Sage N Abstract BACKGROUND: About 75% of patients with minor thoracic injury are discharged after an emergency department visit. However, complications such as delayed hemothorax can occur. We sought to derive and validate a clinical decision rule to predict hemothorax in patients discharged from the emergency department. METHODS: We conducted a 6-year prospective cohort study in 4 university-affiliated emergency departments. Patients aged 16 years or older presenting with a minor thoracic injury were assessed at 5 time points (initial visit and 7, 14, 30 and 90 d after the injury). Radiologists' reports were reviewed for the presence of hemothorax. We used log-binomial regression models to identify predictors of hemothorax. RESULTS: A total of 1382 patients were included: 830 in the derivation phase and 552 in the validation phase. Of these, 151 (10.9%) had hemothorax at the 14-day follow-up. Patients 65 years of age or older represented 25.3% (210/830) and 23.7% (131/552) of the derivation and validation cohorts, respectively. The final clinical decision rule included a combination of age (> 70 yr, 2 points; 45-70 yr, 1 po...
Source: cmaj - Category: General Medicine Authors: Tags: CMAJ Open Source Type: research