title: The Association between Blunt Cardiac Injury and Isolated Sternal Fracture.
abstract: The treatment of isolated sternal fractures (ISF) throughout the world is heterogeneous. This study aimed to identify the incidence, morbidity, and mortality associated with isolated fractures of the sternum and describe current practice for diagnosis and management of ISF and cardiac injury at a level I trauma center in the UK. A retrospective cohort study of adult patients (>16 years) with ISF presenting from 2006 to 2010 was conducted. Eighty-eight patients with ISF were identified. Most patients (88%, 77) were admitted to hospital with 66% (58) of them discharged within 48 hours. Two (2%) patients had an ER EKG with abnormality but both resolved to normal sinus rhythm within 6 hours of follow-up. Serum CEs were drawn from 55 (63%) patients with only 2 (2%) having a rise in serum troponin >0.04; however, in both of these patients troponin quickly normalized. Six (7%) patients underwent echocardiograms without significant findings. In all 88 patients with ISF, no cases of clinically significant cardiac injury were identified. Patients presenting with an isolated sternal fracture with no changes on EKG or chest X-ray do not warrant an admission to hospital and may be discharged from the ER.
authors.affiliation: Center for Translational Injury Research (CeTIR), Department of Surgery, University of Texas-Houston, 6431 Fannin Street, Houston, TX 77030, USA ; Department of Emergency Medicine, Aberdeen Royal Infirmary, University of Aberdeen School of Medicine, Aberdeen AB25 2ZN, UK ; Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
authors.forename: Anahita
authors.identifier: 0000-0001-8335-3933
authors.initials: A
authors.lastname: Dua
authors.affiliation: Department of Emergency Medicine, Aberdeen Royal Infirmary, University of Aberdeen School of Medicine, Aberdeen AB25 2ZN, UK ; Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: McMaster
authors.affiliation: Department of Medicine, Medical University of Lublin, 20 080 Lublin, Poland.
authors.forename: Pathik J
authors.initials: PJ
authors.lastname: Desai
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Sapan S
authors.initials: SS
authors.lastname: Desai
authors.affiliation: Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
authors.forename: Sreyram
authors.initials: S
authors.lastname: Kuy
authors.affiliation: Department of Emergency Medicine, Aberdeen Royal Infirmary, University of Aberdeen School of Medicine, Aberdeen AB25 2ZN, UK.
authors.forename: Maggy
authors.initials: M
authors.lastname: Mata
authors.affiliation: Department of Emergency Medicine, Aberdeen Royal Infirmary, University of Aberdeen School of Medicine, Aberdeen AB25 2ZN, UK.
authors.forename: Jamie
authors.initials: J
authors.lastname: Cooper