Prospective Evaluation of Missed Musculoskeletal Injuries in Trauma Prevent Study

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-06-23 DOI:10.1111/jep.70182

Serena S. Hong, Elise Tcharkhedian, William O'Regan, Joseph Descallar, Scott D'Amours

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Abstract

Background

Physiotherapists are not routinely involved in tertiary survey of trauma patients but are well equipped to perform the musculoskeletal component of the tertiary survey (MSK tertiary survey) to detect any injuries that are missed during primary and secondary surveys.

Aim

To observe and evaluate MSK tertiary surveys completed by physiotherapists in the early identification of missed musculoskeletal injuries in trauma patients.

Methods

The study included a convenience sample of patients over 18 years old admitted under the Trauma team. Patients were allocated to P group if the physiotherapists conducted MSK tertiary survey before the trauma team. Patients were allocated to T group if the admitting Trauma team conducted a tertiary survey before the physiotherapists. McNemar's test was used to compare the discordance of new findings and missed injuries between the Trauma team's tertiary survey and the physiotherapists’ MSK tertiary survey within each of the groups.

Results

Two-hundred twenty-four patients were enrolled into P group and 436 patients were enrolled into T group. In the T group, 26 patients (6%) were identified with new confirmed injuries, of which physiotherapists identified 8 patients (1.9%). In the P group, 8 patients (4%) were identified with confirmed injuries, of which, physiotherapists identified 3 patients (2.4%). The discrepancies of identifying missed injuries between the trauma teams and physiotherapists in T or P group were not significant (p = 0.81, p = 0.25 respectively). No adverse events were reported.

Conclusion

Physiotherapists can conduct MSK tertiary surveys safely in the care of trauma patients as an adjunct to Trauma team-led tertiary survey to identify any missed musculoskeletal injuries in admitted trauma patients.

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创伤预防研究中遗漏的肌肉骨骼损伤的前瞻性评价

物理治疗师通常不参与创伤患者的三级调查，但他们有能力进行三级调查的肌肉骨骼部分（MSK三级调查），以发现在初级和二级调查中遗漏的任何损伤。目的观察和评价物理治疗师完成的MSK三级调查在早期识别创伤患者遗漏的肌肉骨骼损伤中的作用。方法本研究选取创伤科收治的18岁以上患者作为方便样本。物理治疗师在创伤组前进行MSK三级调查，将患者分为P组。如果入院创伤组在物理治疗师之前进行了第三次调查，则将患者分配到T组。McNemar测试用于比较创伤小组第三次调查和物理治疗师MSK第三次调查中新发现和遗漏损伤的不一致性。结果P组2424例，T组436例。在T组中，26例患者（6%）被确定为新确认的损伤，其中物理治疗师确定了8例患者（1.9%）。P组确诊损伤8例（4%），其中物理治疗师确诊3例（2.4%）。创伤组和物理治疗师在T组和P组之间对漏诊损伤的识别差异无统计学意义（P = 0.81, P = 0.25）。无不良事件报告。结论物理治疗师可以在创伤患者的护理中安全地进行MSK三级调查，作为创伤小组领导的三级调查的辅助，以确定住院创伤患者中任何遗漏的肌肉骨骼损伤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.