Number of rib fractures thresholds independently predict worse outcomes in older patients with blunt trauma

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 retr...

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Bibliographic Details
Published in:Surgery 2017-04, Vol.161 (4), p.1083-1089
Main Authors: Shulzhenko, Nikita O., BA, Zens, Tiffany J., MD, Beems, Megan V., MD, Jung, Hee Soo, MD, O'Rourke, Ann P., MD, MPH, Liepert, Amy E., MD, Scarborough, John E., MD, Agarwal, Suresh K., MD
Format: Article
Language:English
Subjects:
Age Factors
Aged
Aged, 80 and over
Cause of Death
Combined Modality Therapy
Comorbidity
Databases, Factual
Female
Geriatric Assessment
Hospital Mortality
Humans
Injury Severity Score
Intensive Care Units
Length of Stay
Linear Models
Logistic Models
Male
Multivariate Analysis
Pneumonia, Ventilator-Associated - mortality
Prognosis
Respiration, Artificial - adverse effects
Retrospective Studies
Rib Fractures - diagnostic imaging
Rib Fractures - mortality
Rib Fractures - therapy
Risk Assessment
Sex Factors
Surgery
Survival Analysis
Trauma Centers
Treatment Outcome
Wounds, Nonpenetrating - diagnostic imaging
Wounds, Nonpenetrating - mortality
Wounds, Nonpenetrating - therapy
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Summary: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  
ISSN:0039-6060
1532-7361
DOI:10.1016/j.surg.2016.10.018