What is the relationship between the Number of Significant rib fractures and Haemothorax in adults with blunt chest trauma?

BACKGROUND

The study aimed to determine the correlation between the number of significant rib fractures in patients with blunt chest trauma (BCT) and the amount of haemothorax as recorded by Closed Thoracostomy Tube Drainage (CTTD).

METHODOLOGY: This was a cross-sectional study of all patients with significant rib fractures following BCT over a period of two years. "Significant rib fractures" was defined as the fracture of 3 or more ribs with 50% or more displacement of each fractured rib edge. Patients with massive haemothorax, patients with severe neurological, or patients who required emergency thoracotomy were excluded.The diagnosis of rib fracture was made by standard chest radiograph or Chest Tomography Scan.Descriptive analyses were reported as mean and standard deviation (SD) for the variables. Pearson correlation test was conducted to test the relationship between the numbers of fractured ribs with the amount of haemothorax as recorded by CTTD with P-value significant at<0.001.

RESULT: Sixteen patients who met the criteria were analysed with a mean age of 46.5years±(SD16.47), the mean number of fractured ribs was 4.5±1.37, the mean amount of drained blood was 605.3ml±(SD244.3) and the mean amount of drained blood per the number of each fractured rib was 134.5ml±54.29.The Pearson Correlation test was strongly positive at,r=0.80 with (P< 0.001).

CONCLUSION

In any patient with BCT, and with fractured of 3 or more ribs, there may be the need to institute a CTTD irrespective of whether the chest radiograph or chest computerized scan shows immediate evidence of significant haemothorax.