Context: Minor thoracic injury causes non-negligible pain that could reduce the cough capacity and can cause infectious problems and atelectasis.
Objectives: To describe the association between atelectasis and cough capacity, and to assess the concordance of cough capacity perceptions between health professionals and the patient.
Design:The data were collected from 2006 to 2012 in 4 Canadian emergency departments (ED).
Participants: Patients with a chief complaint of minor thoracic injury, ≥ 16 years old, discharged home from the ED after an evaluation by the attending physician, were included. They have three visits, at the ED, 7-day and 14-day follow-up. The initial ED visit included medical evaluation, data collection and mandatory chest and rib radiography.
Main outcome measures: The presence of atelectasis was noted at the initial ED and subsequent visits.Participants cough capacity was noted by a physician, a nurse and the patients himself at subsequentvisits and classified as good, diminished, weak /absent.
Results: Among the 1474 patients, 8.89% (95% CI: 7.55 - 10.47), 7.33% (95% CI: 6.04 – 8.89) and 4.63% (95% CI: 3.51 – 6.09) had atelectasis at the initial visit, 7-day and 14-day follow-up visit respectively. Except for patients with weak or absent cough capacity at the 7-day visit, which had a 2.89 (95%CI: 2.05 – 4.05) folds atelectasis proportion relative to those with a good cough capacity, they were no associations between cough capacity and atelectasis. The weighted kappa coefficient suggests a moderate to substantial agreement between the cough capacity measured by patients and nurses (0.52 to 0.65).
Conclusion: There was not strong evidence of an association between atelectasis and cough capacity and the best agreement between cough capacity perception was between nurses and patients.