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In a review of registry data from three level I pediatric trauma centers in Ontario, investigators determined if initial chest radiograph findings in children with blunt thoracic trauma can predict need for thoracic computed tomography (CT) to identify intrathoracic injuries. Children with Injury Severity scores ≥12 were included in the analysis.
Of 425 patients (mean age, 10 years), 174 (41%) underwent CT and 170 (40%) had significant thoracic injuries (defined as hemothorax, pneumothorax, flail chest, or vascular injuries on CT). The odds of a significant thoracic injury increased with the presence of hydrothorax, pneumothorax, or both (adjusted odds ratio, 11) and isolated subcutaneous emphysema (OR, 20). A normal chest x-ray result was n…