Risk factors for late pneumothorax in patients with minor rib fractures after blunt chest trauma

Introduction: Traumatic pneumothorax is a preventable cause of death in trauma patients. Treatment of small traumatic pneumothorax without respiratory distress is controversial. In this study, we tried to determine the risk factors for the development of late traumatic pneumothorax and the safety of treatment with observation in appropriate patients. Material and Methods: Between August 2020 and December 2023, 167 patients admitted to the emergency department for blunt chest trauma with less than 4 rib fractures were retrospectively analyzed. Age, gender, mechanism of trauma, number of rib fractures, rib fracture location, concomitant traumas and pulmonary complications were recorded. Results: The study included 167 patients. There were 107 males (%) and 60 females (%). The age of the patients ranged from 17 to 89 years (mean, 52.6 years). Early pneumothorax was seen in 10 patients (0.59%) and late pneumothorax in 9 patients (0.53%). In statistical analysis, there was a significant correlation between late pneumothorax and the number of rib fractures (p=0.001) and subcutaneous emphysema (p=0.023). There was no significant association between late pneumothorax and other parameters. Conclusion: Increased number of rib fractures and pulmonary complications are harbingers of traumatic pneumothorax. Observation is an adequate treatment modality in late pneumothoraxes without respiratory distress and radiologic progression.