CT as a first line modality in stable blunt chest trauma elderly patients

Abstract Purpose Blunt thoracic injuries are common among elderly patients and may be a common cause of morbidity and death from blunt trauma injuries. We aimed to examine the impact of chest CT on the diagnosis and change of management plan in elderly patients with stable blunt chest trauma. We hypothesized that chest CT may play an important role in providing optimal management to this subgroup of trauma patients. Methods A retrospective analysis was performed on all admitted adult blunt trauma patients between January 2014 and December 2018. Stable blunt chest trauma patients with abbreviated injury severity (AIS) Results There are 473 patients with blunt chest trauma were included in the study. The study patients were divided into two groups according to age range. Group 1: 289 patients were included and aged 18-64 years (36.2 ± 15.6 years). Group 2: 184 patients were included and aged 65-99 years (81.6±17 years). Older patients often more require ICU admission (11.4% vs. 5.2%), had longer length of ICU stay (day) (7±9.4 vs. 2.5±3.2, p = 0.04), and length of hospital stay (day) (12.6±15.5 vs. 4.5±5, p = 0.01). Injuries identified on chest CT has led to a change of management in 10.9% of elderly and in 4.4% of young patients with initially normal CXR. Chest CT resulted in a change of management in 25.7% of older patients and in 12.8% of younger patients with initially abnormal CXR. Conclusion Chest CT led to a change of management in a substantial proportion of elderly patients, therefore, we recommend chest CT as a first-line imaging modality in patients aged over 65 years with isolated blunt chest trauma.