Myth of Delayed Pneumothorax after Scapula Fracture: Scapula Fracture Alone Does Not Raise Morbidity
Stephanie D. Talutis1, Kevin Arndt1, Rainjade Chung1, Gustavo Bauza2, Tejal S. Brahmbhatt1, Tracey Dechert1
1Boston Medical Center, Boston, MA, USA; 2Rutgers Robert Wood Johnson Medical Center, New Brunswick, NJ, USA.
Background: Limited data on scapula fractures (SF) suggest that affected patients must be observed up to 72 hours to evaluate for possible delayed pneumothorax (PTX). The aim of this study is to describe the incidence of delayed PTX in patients with SF and to evaluate the influence of concurrent PTX on morbidity and mortality.
Methods: Retrospective review of patients admitted to a Level 1 Trauma Center (1/1/14 – 5/31/16) with admission diagnosis of SF and/or PTX. Patients were divided into 3 groups: 1) SF only, 2) PTX only, 3) SF+PTX. Analysis was conducted using Chi square (categorical variables) and ANOVA (continuous variables). Significance defined as a two-sided p <0.05.
Results: 283 patients were included. 71 (25.1%) patients had diagnosis of SF, 238 (84.1%) with PTX, and 26 (9.2%) had both SF+PTX. In group 3, there were no incidences of delayed PTX. Patients with SF had lower Injury Severity Score and Chest Abbreviated Injury Score than those in groups 2 and 3(p <0.0001). Patients in group 1 had shorter LOS than those in group 2. Those in group 3 had the longest LOS. Table 1 describes the incidence of associated injuries, dispositions, and outcomes.
Conclusion: Despite literature suggesting that patients with SF require prolonged observation to monitor for delayed PTX, all patients within the cohort who had SF and PTX presented with both diagnoses at admission.
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