Abstract
Background
Optimized conservative treatment of rib fractures has long been practiced, but surgical
fixation has not been promising until recently. We aimed to examine and analyze immediate
postoperative outcomes and 6-month quality of life after injury in patients with moderately
severe traumatic rib fractures.
Methods
We conducted a prospective cohort study between July 2017 and June 2019 at the National
Taiwan University Hospital. Seventy-two patients with moderately severe thoracic trauma
were enrolled; 38 received conservative treatment and 34 underwent surgical fixation.
Quality of life was measured using the 36-item Short Form Survey at; the first 3 days
of hospitalization; before discharge; and at 1-, 2-, and 6-month follow-ups (visits
1–5). Baseline characteristics and clinical outcomes were recorded, and linear regression
analysis was conducted using the generalized estimating equation.
Results
Among patients with moderately severe thoracic injury (chest Abbreviated Injury Scale
score≥ 2), the operative group had more severe injuries and longer intensive care
unit and in-hospital stays. However, they had a comparable quality of life 6 months
after injury and higher physical component scores in the early postoperative period.
Linear regression analysis obtained an equation with several factors positively affecting
prediction of the mean physical component score, such as body mass index ≤25, age
≤36 years, fewer ribs requiring fixation, and diabetes mellitus. Mental component
score did not show an upward trend, but the Work Quality Index largely determined
the predicted mean value of the mental component score.
Conclusion
Surgical rib fixations hasten recovery in patients with severe thoracic injury (chest
Abbreviated Injury Scale ≥3) to achieve 6-month quality of life comparable to patients
injured less severely (chest Abbreviated Injury Scale ≥2). The ability to resume previous
work positively influenced the mental component score; thus, surgical intervention
should also aim to help patients regain their social function.
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Article info
Publication history
Published online: January 17, 2023
Accepted:
December 12,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
