Authors: Khalid A. Ateyyah , Khalid A. Ateyyah

Abstract

The prognosis for patients with thoracic trauma depends largely on the management presented in the emergency department (ED), along with other major factors. This PRISMA scoping review explored ED management for patients with thoracic trauma. A systematic review study was conducted and initially, 157 articles were identified through database research. After screening, following the inclusion and exclusion criteria, and checking for other eligibility conditions, the studies were reduced to 11 articles. Each included study was assessed for quality independently by two reviewers using a modified form of the quality assessment of diagnostic accuracy studies (QUADAS-2). The survival rate following emergency thoracotomy is approximately 9%-12%, whereas, for blunt trauma, the survival rate is 1%-2%. 85% of patients may be treated by emergency physicians after employing minor procedures. The frequency of hospitalization reduced to 24% from 49% along with a decline in the duration of hospitalization. The diagnostic accuracy for ultrasonography (US) is 80% with sensitivity and specificity for any rib fracture, whereas the efficacy of computed tomography scans for independent use is controversial. The findings outlined that the management given in the ED to the patients with thoracic trauma is significantly effective witnessing the decline in the rate of hospitalizations as well as hospital re-admissions, duration of hospital stay, and mortality rate. However, diagnostic tools are still surrounded by controversies and contradictory results, which need intensive investigation to guarantee the validation of the diagnosis.

Keywords: Thorax, trauma, emergency departments, ultrasonography