Increasing Numbers of Rib Fractures Do Not Worsen Outcome: An Analysis of the National Trauma Data Bank

Abstract

Increasing age and number of rib fractures are thought to portend a worse outcome with blunt chest trauma, although this is not clearly substantiated in the literature. We hypothesized that these parameters have a significant and synergistic effect, worsening patient outcome. Using the National Trauma Data Bank, we evaluated patients from 2002 to 2006. Patients with a rib fracture International Classification of Diseases, 9th Revision code were included; those with sternal fractures were excluded. Data on demographics, injury, comorbidity, complications, intensive care unit duration, ventilator duration, length of stay, and death were collected. Significant univariate predictors were included in the multivariate logistic regression analysis to adjust for any potential confounders. We identified 35,467 patients who met the inclusion. The mean age was 45.5 years with a mean Injury Severity Score of 19.3. There were 2.1 per cent open rib fractures. Using univariate analysis, rib fracture number was significant. However, once multivariate analyses were applied, the number of rib fractures was not found to be an independent predictor of outcome. The number of rib fractures is not an independent predictor of outcome. Age and overall trauma burden are more powerful predictors of poor outcomes. Treatment focus should shift from the chest to the broader scope of injuries and comorbidities.

Morbidity and Mortality After Rib Fracture in Elderly Patients (>65 Years Old) Compared to a Younger Cohort (≤65 Years of Age) at Doctor Hospital Renaissance Health

“…Accordingly, recent nationwide studies by Peek et al [29] and Kishawi et al [30] reported mortality rates of 2.1-2.5% among patients with isolated rib fractures with HLOS, LOS, and DOV similar to those observed in our study [29]. Furthermore, newer studies are indicating that NRF is not associated with worst mortality, HLOS, ICU-LOS, or days on mechanical ventilation [31][32], unlike those of Bulger et al [3], Stawicki et al [25], and Pape et al [26]. Their studies all noted a positive association between NRF and mortality.…”

Outcomes after rib fractures: more complex than a single number

“…Furthermore, as age increased, low-risk mechanisms of injury, such as falls, comprised the overwhelming number of admissions. A recent analysis of the National Trauma Data Bank examined all patients with rib fractures in the United States from 2002 to 2006 and reported a mean age of 45.8 years and an overall mortality rate of 8% [17]. Our patient population was older than this cohort, with a median age of 57 years at the time of hospitalization, and had a lower in-hospital and 30-day mortality rate of 4.1%.…”

Risk Factors for Delayed Pleuroparenchymal Complications in Patients with Rib Fractures: Descriptive Research

“…2002 ile 2006 yılları arasında kaburga kırığı olan 35.467 hastayı inceledikleri çalışmalarında, kaburga kırığı sayısının prognoz için bağımsız bir faktör olmadığı ve yaş, travma tipi ve komorbiditenin morbidite ve mortalitenin en güçlü belirleyicileri olduğu sonucuna varmışlardır. 6 Literatürdeki çalışmalar genelde hem yatış sırasında ve hem yatıştan sonra ortaya çıkan komplikasyonların risk faktörlerini birlikte ortaya koyan çalışmalardır. Biz yatış sırasında plöroparankimal komplikasyon var olan hastaları çalışmadan hariç tutarak sadece geç dönem plöroparankimal komplikasyon gelişen hastaları inceledik.…”