Isolated Thoracic Injury Patients With Rib Fractures Undergoing Rib Fixation Have Improved Mortality
| Autor: | Sebastian D. Schubl, Alliya S Qazi, Jeffry Nahmias, Allen Kong, Areg Grigorian, Michael Lekawa, Matthew Dolich, Eric O. Yeates |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Rib Fractures Thoracic Injuries 03 medical and health sciences 0302 clinical medicine Thoracic injury medicine Risk of mortality Humans Aged Retrospective Studies Fixation (histology) Abbreviated Injury Scale business.industry Trauma quality improvement program Emergency department Length of Stay Middle Aged Surgery Logistic Models medicine.anatomical_structure 030220 oncology & carcinogenesis Abdomen Injury Severity Score Female 030211 gastroenterology & hepatology business |
| Zdroj: | Journal of Surgical Research. 262:197-202 |
| ISSN: | 0022-4804 |
| Popis: | Despite a lack of consensus recommendations for surgical stabilization of rib fractures (SSRF), SSRF has increased over the past decade. Outcomes of patients with isolated thoracic injuries undergoing SSRF are unknown. We hypothesized adult trauma patients with isolated thoracic injuries and rib fractures undergoing SSRF would have a decreased risk of mortality and in-hospital respiratory complications compared with those not undergoing SSRF.The Trauma Quality Improvement Program (2010-2016) was queried for patients presenting with a rib fracture. Patients who died in the emergency department or within 24-h, as well as those with a grade1 for abbreviated injury scale of the head, face, neck, spine, abdomen, and extremities, were excluded. A multivariable logistic regression analysis was performed.From 60,000 patients with isolated thoracic injuries and rib fractures, 688 (1.1%) underwent SSRF. Compared with patients without SSRF, those undergoing SSRF had a similar median age (P = 0.83) and higher injury severity score (P 0.001). Patients undergoing SSRF had a longer length of stay (P 0.001), higher rate of acute respiratory distress syndrome (P 0.001), unplanned intubation (P 0.001), and pneumonia (P 0.001) but lower rate of mortality (0.9% versus 1.7%, P = 0.084). After adjusting for confounding variables, patients undergoing SSRF had a decreased associated risk of mortality (OR 0.40, P = 0.036) compared with those not undergoing SSRF.The risk of mortality in trauma patients with isolated thoracic injuries and rib fractures is lower when undergoing SSRF despite being associated with a higher rate of respiratory complications during their increased length of stay. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect