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Are discharged patients who suffer minor thoracic injury at risk of developing delayed pneumonia?
Prospective study of 1,057 patients age 16 and older with minor thoracic injury who were discharged from the ED.
32.8% had at least one rib fracture
8.2% had asthma
3.4% had COPD
Only 6 patients developed pneumonia!!
Sex, smoking, atelectasis on CXR, and alcohol intoxication were not significantly associated with delayed pneumonia.
However, for patients with preexistent pulmonary disease (asthma or COPD) AND rib fracture, the relative risk of delayed pneumonia was 8.6. Patients without either of these conditions are at extremely low risk of future development of pneumonia.
References
Patients with rib fractures do not develop delayed pneumonia: a prospective, multicenter cohort study of minor thoracic injury. Chauny JM, Emond M, Plourde M, Guimont C, Le Sage N, Vanier L, Bergeron E, Dufresne M, Allain-Boulé N, Fratu R. Ann Emerg Med. 2012 Dec;60(6):726-31.