Occult trauma in high-risk populations.
Several groups of patients are at increased risk for traumatic injury that is "occult," or not apparent on initial presentation. Perhaps the most notorious are those who abuse alcohol, but other groups include the elderly, coagulopathic, those with neurological disease, and the mentally ill. Moreover, traumatic injury can coexist with (or be masked by) medical pathology, resulting in the disposition of injured patients to nonsurgical services where surveillance for traumatic injury diminishes. Because delays or failures in diagnosis might result in unnecessary pain, morbidity, and mortality, it is important for the emergency physician to identify occult presentations of trauma before disposition. This review highlights commonly missed traumatic injuries in adult patients.
Shoenberger
Jan M
JM
Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA 90033, USA.
Houpt
Jonathan C
JC
Swadron
Stuart P
SP
D000367:Age Factors; D001778:Blood Coagulation Disorders / Q000150:complications / Q000453:epidemiology; D006703:Ill-Housed Persons; D006801:Humans; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy