Skip to main content

Rib Fracture Location Should Be Evaluated When Predicting Morbidity and Mortality in Trauma Patients.

Publication ,  Conference
Haines, KL; Zens, T; Warner-Hillard, C; DeSouza, E; Jung, HS; Agarwal, S
Published in: Am Surg
September 1, 2018

Rib fractures represent up to 55 per cent of thoracic blunt traumatic injuries and lead to significant mortality and morbidity. The aim of this study is to determine whether not only number but also the location of rib fractures can be used to risk stratify patients. This is a retrospective study of all blunt trauma patients who presented with rib fractures from January 1, 2013 to April 1, 2015 and underwent chest CT. Rib fractures were categorized by location. Primary outcome was mortality, secondary outcomes were total hospital length of stay (LOS), intensive care unit LOS, and disposition. Multivariate regressions were performed to determine whether mortality and morbidity was dependent on the number of rib fractures as related to location. Nine hundred and twenty-nine patients were reviewed, 669 fit inclusion criteria, and 35 patients died. Mean Injury Severity Score (18 ± 10), total number of rib fractures (6 ± 5), and age (54 ± 19) significantly correlated with mortality. LOS correlated with the number of rib fractures (P < 0.001). Flail chest of indeterminate location significantly increased mortality (P = 0.002). Controlling for age, gender, and Injury Severity Score and for every lateral rib fracture, patients were 1.13 times (OR; P = 0.001) more likely to die. Posterior rib fractures only effected patient outcome if the patient has three or more posterior ribs broken and the patient was 45 years of age or older (P = 0.044); these patients were 12 times more likely to die. When evaluating blunt force trauma in patients with rib fractures, it is imperative to look at rib fracture location and not only the number of rib fractures sustained to predict outcomes.

Duke Scholars

Published In

Am Surg

EISSN

1555-9823

Publication Date

September 1, 2018

Volume

84

Issue

9

Start / End Page

1462 / 1465

Location

United States

Related Subject Headings

  • Wounds, Nonpenetrating
  • Surgery
  • Risk Factors
  • Rib Fractures
  • Retrospective Studies
  • Middle Aged
  • Male
  • Length of Stay
  • Injury Severity Score
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Haines, K. L., Zens, T., Warner-Hillard, C., DeSouza, E., Jung, H. S., & Agarwal, S. (2018). Rib Fracture Location Should Be Evaluated When Predicting Morbidity and Mortality in Trauma Patients. In Am Surg (Vol. 84, pp. 1462–1465). United States.
Haines, Krista L., Tiffany Zens, Charles Warner-Hillard, Edwarda DeSouza, Hee Soo Jung, and Suresh Agarwal. “Rib Fracture Location Should Be Evaluated When Predicting Morbidity and Mortality in Trauma Patients.” In Am Surg, 84:1462–65, 2018.
Haines KL, Zens T, Warner-Hillard C, DeSouza E, Jung HS, Agarwal S. Rib Fracture Location Should Be Evaluated When Predicting Morbidity and Mortality in Trauma Patients. In: Am Surg. 2018. p. 1462–5.
Haines, Krista L., et al. “Rib Fracture Location Should Be Evaluated When Predicting Morbidity and Mortality in Trauma Patients.Am Surg, vol. 84, no. 9, 2018, pp. 1462–65.
Haines KL, Zens T, Warner-Hillard C, DeSouza E, Jung HS, Agarwal S. Rib Fracture Location Should Be Evaluated When Predicting Morbidity and Mortality in Trauma Patients. Am Surg. 2018. p. 1462–1465.

Published In

Am Surg

EISSN

1555-9823

Publication Date

September 1, 2018

Volume

84

Issue

9

Start / End Page

1462 / 1465

Location

United States

Related Subject Headings

  • Wounds, Nonpenetrating
  • Surgery
  • Risk Factors
  • Rib Fractures
  • Retrospective Studies
  • Middle Aged
  • Male
  • Length of Stay
  • Injury Severity Score
  • Humans