To investigate the diagnostic value of cough pain in rib fracture.

150 cases of consecutive patients with chest trauma treated in the emergency surgery were enrolled in this prospective cohort study, of which 14 cases were lost. Firstly, ask whether there were cough pain and then take chest X-ray, CT+ scan and three-dimensional reconstruction of the rib. Finally, reexamine the rib CT+ 3D reconstruction of four weeks.The final diagnosis is the results of the rib CT+ 3D reconstruction after four weeks.

In 136 patients, 85 patients were diagnosed as rib fractures, among whom 81 cases have cough symptoms of chest pain. The sensitivity was 95.3% (95% CI, 91.8% to 99.8%). The specificity was 58.8% (95% CI, 45.3% to 72.3%). The positive predictive value was 88% (95% CI, 81.3% to 94.7%). The negative predictive value was 68.2% (95% CI, 54.4% to 82.0%). The positive likelihood ratio was 2.31 (95% CI, 1.80 to 2.97). The negative likelihood ratio was 0.08 (95% CI, 0.04 to 0.17). Chest pain has a higher sensitivity when compared with chest X-ray and immediate rib CT examination.

chest pain during coughing is one of the evidences for the diagnosis of rib fracture. It is helpful for the first visit doctor to make a preliminary evaluation of the patient’s condition, early intervention, and to reduce the incidence of complications.