دورية أكاديمية
Utilization of Percentage of Predicted Forced Vital Capacity to Stratify Rib Fracture Patients: An Updated Clinical Practice Guideline.
| العنوان: | Utilization of Percentage of Predicted Forced Vital Capacity to Stratify Rib Fracture Patients: An Updated Clinical Practice Guideline. |
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| المؤلفون: | Khan AD; Department of Trauma and Acute Care Surgery, UC Health-Memorial Hospital, Colorado Springs, CO, USA., Marlor DR; Department of Trauma and Acute Care Surgery, UC Health-Memorial Hospital, Colorado Springs, CO, USA., Billings JD; Department of Trauma and Acute Care Surgery, UC Health-Memorial Hospital, Colorado Springs, CO, USA., Rodriguez J; Department of Trauma and Acute Care Surgery, UC Health-Memorial Hospital, Colorado Springs, CO, USA., Leininger BE; Department of Trauma and Acute Care Surgery, UC Health-Memorial Hospital, Colorado Springs, CO, USA., Douville AA; Department of Pharmacy, UC Health-Memorial Hospital, Colorado Springs, CO, USA., Clement LP; Department of Pharmacy, UC Health-Memorial Hospital, Colorado Springs, CO, USA., Schroeppel TJ; Department of Trauma and Acute Care Surgery, UC Health-Memorial Hospital, Colorado Springs, CO, USA. |
| المصدر: | The American surgeon [Am Surg] 2022 Apr; Vol. 88 (4), pp. 674-679. Date of Electronic Publication: 2020 Dec 14. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: SAGE Publications in association with Southeastern Surgical Congress Country of Publication: United States NLM ID: 0370522 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1555-9823 (Electronic) Linking ISSN: 00031348 NLM ISO Abbreviation: Am Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2020- : [Thousand Oaks, CA] : SAGE Publications in association with Southeastern Surgical Congress Original Publication: Atlanta Ga : Southeastern Surgical Congress |
| مواضيع طبية MeSH: | Rib Fractures*/complications , Rib Fractures*/diagnosis , Wounds, Nonpenetrating*/complications , Wounds, Nonpenetrating*/diagnosis, Female ; Humans ; Intensive Care Units ; Practice Guidelines as Topic ; Retrospective Studies ; Vital Capacity |
| مستخلص: | Background: Rib fractures are the most common injuries diagnosed after blunt thoracic trauma and are a source of significant morbidity and mortality. Early identification of at-risk patients and initiation of effective analgesia are keys to mitigating complications from these injuries. Multiple tools exist to predict pulmonary decompensation after rib fractures; however, none has found a widespread acceptance. A clinical practice guideline (CPG) utilizing Forced vital capacity (FVC) has been in place at a single institution. The goal of this study is to update the CPG to use percentage of predicted FVC (FVC%) instead of FVC to triage patients with rib fractures. Materials and Methods: A retrospective study of 266 patients with rib fractures was conducted. Patients were divided into 3 groups based on FVC of <1000 mL, 1001-1500 mL, or >1500 mL for analysis. Data were analyzed with analysis of variance, and Youden's J Index was used to identify inflection points. Results: Patients in the high-risk category were more likely to be women, older than 65 years, admitted to the intensive care unit (ICU), transferred to the ICU, require intubation, and have overall longer hospital and ICU stays. The updated CPG triage cutoffs for admission to ICU, stepdown, and floor were redefined as FVC% values of <25%, 25-45%, and >45%, respectively. Discussion: The updated CPG using FVC% may more accurately identify patients with compromised physiology and be a better tool to help predict patients who are at risk for decompensation following rib fractures. A validation study for the updated CPG is in progress. |
| تواريخ الأحداث: | Date Created: 20201214 Date Completed: 20220316 Latest Revision: 20220531 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1177/0003134820956276 |
| PMID: | 33316169 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1555-9823 |
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| DOI: | 10.1177/0003134820956276 |