Background
There have been conflicting reports regarding whether the number of rib fractures
sustained in blunt trauma is associated independently with worse patient outcomes.
We sought to investigate this risk-adjusted relationship among the lesser-studied
population of older adults.
Methods
A retrospective review of the National Trauma Data Bank was performed for patients
with blunt trauma who were ≥65 years old and had rib fractures between 2009 and 2012
(N = 67,695). Control data were collected for age, sex, injury severity score, injury
mechanism, 24 comorbidities, and number of rib fractures. Outcome data included hospital
mortality, hospital and intensive care unit durations of stay, duration of mechanical
ventilation, and the occurrence of pneumonia. Multiple logistic and linear regression
analyses were performed.
Results
Sustaining ≥5 rib fractures was associated with increased intensive care unit admission
(odds ratio: 1.14, P < .001) and hospital duration of stay (relative duration: 105%, P < .001). Sustaining ≥7 rib fractures was associated with an increased incidence of
pneumonia (odds ratio: 1.32, P < .001) and intensive care unit duration of stay (relative duration: 122%, P < .001). Sustaining ≥8 rib fractures was associated with increased mortality (odds
ratio: 1.51, P < .001) and duration of mechanical ventilation (relative duration: 117%, P < .001).
Conclusion
In older patients with trauma, sustaining at least 5 rib fractures is a significant
predictor of worse outcomes independent of patient characteristics, comorbidities,
and trauma burden.
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Article info
Publication history
Published online: December 05, 2016
Accepted:
October 7,
2016
Footnotes
Supported by grants from the University of Wisconsin Department of Surgery and School of Medicine and Public Health.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
