Expert opinion of the risk factors for morbidity and mortality in blunt chest wall trauma: results of a national postal questionnaire survey of Emergency Departments in the United Kingdom.
OBJECTIVE
Blunt chest wall trauma is a common injury treated in the Emergency Departments and has a high reported morbidity and mortality. No national guidelines exist for the management of this patient group unless the patient has severe immediate life-threatening injuries. The aim of this study was to investigate current management of blunt chest wall trauma patients in the UK and to gather expert opinion of the risk factors for morbidity and mortality.


METHODS
A sample of 100 physicians working in Emergency Departments in the UK were purposively selected and sent a postal questionnaire to complete. Non-responder analysis was undertaken in order to assess bias. The completed questionnaires were analysed with descriptive statistics.


RESULTS
A response rate of 90% was achieved. The different type of hospital providing emergency care was well represented in the results. The general surgical team was the most frequently used ward-based team when the patient required admission to hospital (51%). Inconsistencies exist regarding the use of guidelines for the management of the blunt chest wall patient. The risk factors for morbidity and mortality suggested by the sample concurred with current literature including patient age, pre-existing conditions and number of ribs fractured and areas for further research were highlighted.


CONCLUSIONS
Variation exists in the management of blunt chest wall trauma patients in the UK. This study provides the expert opinion of a sample of 90 physicians working in Emergency Departments in the UK regarding the risk factors for morbidity and mortality in blunt chest wall trauma patients.
School of Medicine, University of Wales Swansea, Swansea, Wales, UK. ceri.battle@wales.nhs.uk
Ceri Elisabeth
CE
Battle
Hayley
H
Hutchings
Phillip Adrian
PA
Evans
D000367:Age Factors; D015897:Comorbidity; D020000:Decision Support Systems, Clinical; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality; D011237:Predictive Value of Tests; D011859:Radiography; D012253:Rib Fractures / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013898:Thoracic Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality; D015599:Trauma Severity Indices; D006113:United Kingdom / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality