| Diagnostic accuracy of ultrasonography in the acute assessment of common thoracic lesions after trauma. | |
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MedLine Citation:
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PMID: 22016490 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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AbstractBackground.The accuracy of combined clinical examination (CE) and chest radiography (CXR) (CE+CXR) versus thoracic ultrasonography in the acute assessment of pneumothorax, hemothorax and lung contusion in chest trauma patients is unknown.Methods.We conducted a prospective, observational cohort study involving 119 adult patients admitted to the emergency room with thoracic trauma. Each patient, secured on to a vacuum mattress, underwent a subsequent thoracic CT scan after first receiving a CE, CXR, and thoracic ultrasound. The diagnostic performance of each method was also evaluated in a subgroup of 35 patients with hemodynamic and/or respiratory instability.Results.Of the 237 lung fields included in the study, we observed 53 pneumothoraces, 35 hemothoraces and 147 lung contusions, according to either thoracic CT or thoracic decompression if placed before the CT scan. The diagnostic performance of ultrasonography was higher than that of CE+CXR, as shown by their respective areas under the receiver operating characteristic curves (AUC-ROC): 0.75 (0.67-0.83) (mean, 95% confidence interval) versus 0.62 (0.54-0.70) in pneumothorax cases, and 0.73 (0.67-0.80) versus 0.66 (0.61-0.72) for lung contusions, respectively (all p<0.05). In addition, the diagnostic performance of ultrasonography to detect pneumothorax was enhanced in the most severely injured patients: 0.86 (0.73-0.98) versus 0.70 (0.61-0.80) with CE+CXR. No difference between modalities was found for hemothorax.Conclusions.Thoracic ultrasound as a bedside diagnostic modality is a better diagnostic test than CE and CXR in comparison to CT scanning when evaluating supine chest trauma patients in the emergency setting, particularly for diagnosing pneumothoraces and lung contusions. |
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Authors:
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Anne-Claire Hyacinthe; Christophe Broux; Gilles Francony; Céline Genty; Pierre Bouzat; Claude Jacquot; Pierre Albaladejo; Gilbert R Ferretti; Jean-Luc Bosson; Jean-François Payen |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-10-20 |
Journal Detail:
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Title: Chest Volume: - ISSN: 1931-3543 ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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*Pôle d'Anesthésie-Réanimation, Hôpital Michallon, et Université Joseph Fourier, Grenoble, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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