Academic Journal
View in EDS

O119 Validity of current screening practices for cardiac injury in patients presenting with traumatic sternal fractures

Bibliographic Details
Title: O119 Validity of current screening practices for cardiac injury in patients presenting with traumatic sternal fractures
Authors: Burrows, R, Boardman, S, Spiers, D, Friej, R, Brooks, A, O'Connor, R
Source: British Journal of Surgery ; volume 110, issue Supplement_3 ; ISSN 0007-1323 1365-2168
Publisher Information: Oxford University Press (OUP)
Publication Year: 2023
Description: Introduction Sternal fractures are a common injury found in trauma patients that are transferred to Level I trauma centres. Current practice for patients presenting with a sternal fracture is to perform an electrocardiogram (ECG) and serum troponin. All patients are subsequently admitted for 24 hours of observation with cardiac monitoring, irrespective of the initial investigation findings. We therefore considered the utility of this strategy. Methods Some 209 patients with sternal fractures who presented over a 2 year period were identified from the Trauma Audit and Research Network (TARN) database for retrospective analysis. We considered the predictive value of both ECG and serum troponin in predicting underlying cardiac injury. Results Troponin rise occurred in 44 patients (20% of the cohort). ECG changes were noted in 12 patients (5.5% of cohort). Echocardiograms were performed in 55 patients, of these 6 (10.9%) showed changes potentially relating to trauma. The positive predictive value of these initial investigations to rule out clinically relevant cardiac injury was 0.12 and the negative predictive value was 1.00. Conclusion Within this cohort, a negative troponin and a normal ECG proved in 100% of patients to rule out a clinically relevant cardiac injury. This finding gives weight to these being a valid screening tool not simply to guide further investigation, but to also guide management. Their early use in patients with a sternal fracture could be used to avoid unnecessary admissions for observation and cardiac monitoring. Further exploration of the validity of these findings should consider increasing the number of cases and multicentre studies.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/bjs/znad101.119
Availability: https://doi.org/10.1093/bjs/znad101.119
https://academic.oup.com/bjs/article-pdf/110/Supplement_3/znad101.119/50266474/znad101.119.pdf
Rights: https://academic.oup.com/pages/standard-publication-reuse-rights
Accession Number: edsbas.8B7FCE23
Database: BASE
FullText Text:
  Availability: 0
CustomLinks:
  – Url: https://doi.org/10.1093/bjs/znad101.119#
    Name: EDS - BASE (ns324271)
    Category: fullText
    Text: View record from BASE
Header DbId: edsbas
DbLabel: BASE
An: edsbas.8B7FCE23
RelevancyScore: 926
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 926.330688476563
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: O119 Validity of current screening practices for cardiac injury in patients presenting with traumatic sternal fractures
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Burrows%2C+R%22">Burrows, R</searchLink><br /><searchLink fieldCode="AR" term="%22Boardman%2C+S%22">Boardman, S</searchLink><br /><searchLink fieldCode="AR" term="%22Spiers%2C+D%22">Spiers, D</searchLink><br /><searchLink fieldCode="AR" term="%22Friej%2C+R%22">Friej, R</searchLink><br /><searchLink fieldCode="AR" term="%22Brooks%2C+A%22">Brooks, A</searchLink><br /><searchLink fieldCode="AR" term="%22O'Connor%2C+R%22">O'Connor, R</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: British Journal of Surgery ; volume 110, issue Supplement_3 ; ISSN 0007-1323 1365-2168
– Name: Publisher
  Label: Publisher Information
  Group: PubInfo
  Data: Oxford University Press (OUP)
– Name: DatePubCY
  Label: Publication Year
  Group: Date
  Data: 2023
– Name: Abstract
  Label: Description
  Group: Ab
  Data: Introduction Sternal fractures are a common injury found in trauma patients that are transferred to Level I trauma centres. Current practice for patients presenting with a sternal fracture is to perform an electrocardiogram (ECG) and serum troponin. All patients are subsequently admitted for 24 hours of observation with cardiac monitoring, irrespective of the initial investigation findings. We therefore considered the utility of this strategy. Methods Some 209 patients with sternal fractures who presented over a 2 year period were identified from the Trauma Audit and Research Network (TARN) database for retrospective analysis. We considered the predictive value of both ECG and serum troponin in predicting underlying cardiac injury. Results Troponin rise occurred in 44 patients (20% of the cohort). ECG changes were noted in 12 patients (5.5% of cohort). Echocardiograms were performed in 55 patients, of these 6 (10.9%) showed changes potentially relating to trauma. The positive predictive value of these initial investigations to rule out clinically relevant cardiac injury was 0.12 and the negative predictive value was 1.00. Conclusion Within this cohort, a negative troponin and a normal ECG proved in 100% of patients to rule out a clinically relevant cardiac injury. This finding gives weight to these being a valid screening tool not simply to guide further investigation, but to also guide management. Their early use in patients with a sternal fracture could be used to avoid unnecessary admissions for observation and cardiac monitoring. Further exploration of the validity of these findings should consider increasing the number of cases and multicentre studies.
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: article in journal/newspaper
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1093/bjs/znad101.119
– Name: URL
  Label: Availability
  Group: URL
  Data: https://doi.org/10.1093/bjs/znad101.119<br />https://academic.oup.com/bjs/article-pdf/110/Supplement_3/znad101.119/50266474/znad101.119.pdf
– Name: Copyright
  Label: Rights
  Group: Cpyrght
  Data: https://academic.oup.com/pages/standard-publication-reuse-rights
– Name: AN
  Label: Accession Number
  Group: ID
  Data: edsbas.8B7FCE23
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edsbas&AN=edsbas.8B7FCE23
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1093/bjs/znad101.119
    Languages:
      – Text: English
    Titles:
      – TitleFull: O119 Validity of current screening practices for cardiac injury in patients presenting with traumatic sternal fractures
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Burrows, R
      – PersonEntity:
          Name:
            NameFull: Boardman, S
      – PersonEntity:
          Name:
            NameFull: Spiers, D
      – PersonEntity:
          Name:
            NameFull: Friej, R
      – PersonEntity:
          Name:
            NameFull: Brooks, A
      – PersonEntity:
          Name:
            NameFull: O'Connor, R
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2023
          Identifiers:
            – Type: issn-locals
              Value: edsbas
            – Type: issn-locals
              Value: edsbas.oa
          Titles:
            – TitleFull: British Journal of Surgery ; volume 110, issue Supplement_3 ; ISSN 0007-1323 1365-2168
              Type: main
ResultId 1