Academic Journal
O119 Validity of current screening practices for cardiac injury in patients presenting with traumatic sternal fractures
| Title: | O119 Validity of current screening practices for cardiac injury in patients presenting with traumatic sternal fractures |
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| 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 |
| DOI: | 10.1093/bjs/znad101.119 |
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