INJURIES MISSED DURING INITIAL ASSESSMENT OF BLUNT TRAUMA PATIENTS

Objective: To determine the incidence and clinical significance of undiagnosed injuries in blunt trauma patients at our institution. Design: Retrospective analysis of blunt trauma admissions over a 1-year period. Missed injury (MI) was defined as any injury recorded after the initial 24 hours. Results: Of 432 patients studied, 59 (13.6%) had MI. Fractures were the most common MI. Thirty-five percent of MI were detected during repeated physical examination and 28% after patients were conscious and able to voice concerns. Conclusion: Over 10% of all blunt trauma patients had undiagnosed injuries. Forty percent of the MI had clinical implications. The most effective method of diagnosis consists of repeated clinical assessments. Special attention should be focused on patients with severe anatomical injuries, obtunded or intubated.