The role of routine chest radiography in initial evaluation of stable blunt trauma patients.
BACKGROUND
Radiology plays an important role in evaluation of a trauma patient. Although chest radiography is recommended for initial evaluation of the trauma patient by the Advanced Trauma Life Support course, we hypothesized that precise physical examinations and history taking accurately identify those blunt trauma patients at low risk for chest injury, making routine radiographs unnecessary. Thus, this study was performed to investigate the role of chest radiography in initial evaluation of those trauma patients with normal physical examination.


METHODS
In this prospective cross-sectional study, all the hemodynamically stable blunt trauma patients with negative physical examination result referred to our trauma center during a 4-month period (March-June 2009) were included. Chest radiographies were performed and reviewed for abnormalities.


RESULTS
During the study period, 5091 blunt trauma patients referred to our center, out of which, 1008 were hemodynamically stable and had negative physical examination result. Only 1 (0.1%) patient had abnormal chest radiography that showed perihilar lymphadenopathy, unrelated to trauma.


CONCLUSIONS
Performing routine chest radiography in stable blunt trauma patients is of low clinical value. Thus, decision making for performing chest radiography in blunt trauma patients based on clinical findings would be efficacious and resource saving.
Nemazee Hospital affiliated with Shiraz University of Medical Sciences, Shiraz, Iran.
Shahram
S
Paydar
Hamed Ghoddusi
HG
Johari
Fariborz
F
Ghaffarpasand
Danial
D
Shahidian
Afsaneh
A
Dehbozorgi
Bijan
B
Ziaeian
Shahram
S
Bolandparvaz
Hamid Reza
HR
Abbasi
Maryam
M
Sharifian
D000328:Adult; D003430:Cross-Sectional Studies; D003955:Diagnostic Tests, Routine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination / Q000379:methods; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013902:Radiography, Thoracic / Q000706:statistics & numerical data; D014193:Trauma Centers / Q000706:statistics & numerical data; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000000981:diagnostic imaging*