Long-term quality of life and functional outcome after rib fracture fixation
Purpose The primary aim of this study was to assess the long-term quality of life and functional outcome after rib fracture fixation for patients with multiple rib fractures or flail chest. Secondarily, this study sought to identify risk factors associated with the quality of life. Methods A retrosp...
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| Veröffentlicht in: | European journal of trauma and emergency surgery (Munich : 2007) 2022-02, Vol.48 (1), p.255-264 |
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| creator | Peek, Jesse Kremo, Valerie Beks, Reinier van Veelen, Nicole Leiser, Alfred Link, Björn-Christian Houwert, Roderick M. Minervini, Fabrizio Knobe, Matthias Babst, Reto H. Beeres, Frank J. P. |
| description | Purpose
The primary aim of this study was to assess the long-term quality of life and functional outcome after rib fracture fixation for patients with multiple rib fractures or flail chest. Secondarily, this study sought to identify risk factors associated with the quality of life.
Methods
A retrospective cohort study with a follow-up by questionnaire was performed at a level-1 trauma center in Switzerland. All adult patients with three or more rib fractures treated with rib fixation between 2010 and 2018 were eligible for inclusion. All outcomes were independently assessed for patients with multiple rib fractures and patients with a flail chest. The outcome measures were quality of life, level of dyspnea, return to work, implant irritation, and implant removal after a minimum of 12 months of follow-up. Quality of life was assessed using the EuroQol five-dimensional five-level questionnaire (EQ-5D-5L) and level of dyspnea was determined with the modified Medical Research Council dyspnea (mMRC) scale.
Results
The survey was completed by 74 out of 102 patients (73%) at a median follow-up of 26 months (IQR 15–37). The median EQ-5D utility index score was 0.91 (0.89–1.0), which was equivalent to the reference population (0.902,
p
= 0.523). The vast majority of patients experienced ‘no problems’ or ‘slight problems’ in any of the EQ-5D-5L dimensions. The complication rate associated with rib fracture fixation was low, implant-related irritation was the most common long-term sequela and occurred in 31% of patients. In multivariable regression analyses, total length of stay on the intensive care unit (ICU-LOS) was independently associated with a worse quality of life.
Conclusions
Patients who underwent rib fracture fixation for multiple rib fractures or flail chest after severe chest trauma experienced a good quality of life at least 1 year after surgery. A longer ICU-LOS was independently associated with impaired quality of life. In addition, there were no significant differences in the long-term quality of life and functional outcome between patients with multiple rib fractures and a flail chest. Implant-related irritation was the most important long-term sequela and occurred in one-third of patients. |
| doi_str_mv | 10.1007/s00068-020-01470-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2439632587</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2439632587</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-5cdda6ddbbe2d1ef9b1c97f5a6e94d8e53446a4ead71ae8e6c4c3ab2692844743</originalsourceid><addsrcrecordid>eNp90MtKxDAUBuAgiuPtBVxIwI2bam5N2qWINxhwo-uQJidDh7aZSVrQtzfj6AguXCUk3_lDfoTOKbmmhKibRAiRVUEYKQgVihRyDx3RSvKirgXd3-05n6HjlJZZE1myQzTjrFJSKXaE5vMwLIoRYo_Xk-na8QMHj7vWAzaDw34a7NiGwXQ4TKMNfT72WePYNthHY8cpAvbtu9moU3TgTZfg7Hs9QW8P9693T8X85fH57nZeWK7KsSitc0Y61zTAHAVfN9TWypdGQi1cBSUXQhoBxilqoAJpheWmYbJmlRBK8BN0tc1dxbCeII26b5OFrjMDhClpJngtOSsrlenlH7oMU8z_yUoyKWQpqMyKbZWNIaUIXq9i25v4oSnRm671tmudu9ZfXevN0MV39NT04HYjP-VmwLcg5athAfH37X9iPwH_hooH</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2626465416</pqid></control><display><type>article</type><title>Long-term quality of life and functional outcome after rib fracture fixation</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Peek, Jesse ; Kremo, Valerie ; Beks, Reinier ; van Veelen, Nicole ; Leiser, Alfred ; Link, Björn-Christian ; Houwert, Roderick M. ; Minervini, Fabrizio ; Knobe, Matthias ; Babst, Reto H. ; Beeres, Frank J. P.</creator><creatorcontrib>Peek, Jesse ; Kremo, Valerie ; Beks, Reinier ; van Veelen, Nicole ; Leiser, Alfred ; Link, Björn-Christian ; Houwert, Roderick M. ; Minervini, Fabrizio ; Knobe, Matthias ; Babst, Reto H. ; Beeres, Frank J. P.</creatorcontrib><description>Purpose
The primary aim of this study was to assess the long-term quality of life and functional outcome after rib fracture fixation for patients with multiple rib fractures or flail chest. Secondarily, this study sought to identify risk factors associated with the quality of life.
Methods
A retrospective cohort study with a follow-up by questionnaire was performed at a level-1 trauma center in Switzerland. All adult patients with three or more rib fractures treated with rib fixation between 2010 and 2018 were eligible for inclusion. All outcomes were independently assessed for patients with multiple rib fractures and patients with a flail chest. The outcome measures were quality of life, level of dyspnea, return to work, implant irritation, and implant removal after a minimum of 12 months of follow-up. Quality of life was assessed using the EuroQol five-dimensional five-level questionnaire (EQ-5D-5L) and level of dyspnea was determined with the modified Medical Research Council dyspnea (mMRC) scale.
Results
The survey was completed by 74 out of 102 patients (73%) at a median follow-up of 26 months (IQR 15–37). The median EQ-5D utility index score was 0.91 (0.89–1.0), which was equivalent to the reference population (0.902,
p
= 0.523). The vast majority of patients experienced ‘no problems’ or ‘slight problems’ in any of the EQ-5D-5L dimensions. The complication rate associated with rib fracture fixation was low, implant-related irritation was the most common long-term sequela and occurred in 31% of patients. In multivariable regression analyses, total length of stay on the intensive care unit (ICU-LOS) was independently associated with a worse quality of life.
Conclusions
Patients who underwent rib fracture fixation for multiple rib fractures or flail chest after severe chest trauma experienced a good quality of life at least 1 year after surgery. A longer ICU-LOS was independently associated with impaired quality of life. In addition, there were no significant differences in the long-term quality of life and functional outcome between patients with multiple rib fractures and a flail chest. Implant-related irritation was the most important long-term sequela and occurred in one-third of patients.</description><identifier>ISSN: 1863-9933</identifier><identifier>EISSN: 1863-9941</identifier><identifier>DOI: 10.1007/s00068-020-01470-6</identifier><identifier>PMID: 32876772</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Critical Care Medicine ; Dyspnea ; Emergency medical care ; Emergency Medicine ; Fracture Fixation ; Fracture Fixation, Internal ; Fractures ; Humans ; Intensive ; Length of Stay ; Medicine ; Medicine & Public Health ; Original Article ; Quality of Life ; Questionnaires ; Retrospective Studies ; Rib cage ; Rib Fractures - surgery ; Ribs ; Sports Medicine ; Surgery ; Surgical Orthopedics ; Trauma ; Traumatic Surgery</subject><ispartof>European journal of trauma and emergency surgery (Munich : 2007), 2022-02, Vol.48 (1), p.255-264</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>2020. Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-5cdda6ddbbe2d1ef9b1c97f5a6e94d8e53446a4ead71ae8e6c4c3ab2692844743</citedby><cites>FETCH-LOGICAL-c375t-5cdda6ddbbe2d1ef9b1c97f5a6e94d8e53446a4ead71ae8e6c4c3ab2692844743</cites><orcidid>0000-0003-0667-4076</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00068-020-01470-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00068-020-01470-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32876772$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peek, Jesse</creatorcontrib><creatorcontrib>Kremo, Valerie</creatorcontrib><creatorcontrib>Beks, Reinier</creatorcontrib><creatorcontrib>van Veelen, Nicole</creatorcontrib><creatorcontrib>Leiser, Alfred</creatorcontrib><creatorcontrib>Link, Björn-Christian</creatorcontrib><creatorcontrib>Houwert, Roderick M.</creatorcontrib><creatorcontrib>Minervini, Fabrizio</creatorcontrib><creatorcontrib>Knobe, Matthias</creatorcontrib><creatorcontrib>Babst, Reto H.</creatorcontrib><creatorcontrib>Beeres, Frank J. P.</creatorcontrib><title>Long-term quality of life and functional outcome after rib fracture fixation</title><title>European journal of trauma and emergency surgery (Munich : 2007)</title><addtitle>Eur J Trauma Emerg Surg</addtitle><addtitle>Eur J Trauma Emerg Surg</addtitle><description>Purpose
The primary aim of this study was to assess the long-term quality of life and functional outcome after rib fracture fixation for patients with multiple rib fractures or flail chest. Secondarily, this study sought to identify risk factors associated with the quality of life.
Methods
A retrospective cohort study with a follow-up by questionnaire was performed at a level-1 trauma center in Switzerland. All adult patients with three or more rib fractures treated with rib fixation between 2010 and 2018 were eligible for inclusion. All outcomes were independently assessed for patients with multiple rib fractures and patients with a flail chest. The outcome measures were quality of life, level of dyspnea, return to work, implant irritation, and implant removal after a minimum of 12 months of follow-up. Quality of life was assessed using the EuroQol five-dimensional five-level questionnaire (EQ-5D-5L) and level of dyspnea was determined with the modified Medical Research Council dyspnea (mMRC) scale.
Results
The survey was completed by 74 out of 102 patients (73%) at a median follow-up of 26 months (IQR 15–37). The median EQ-5D utility index score was 0.91 (0.89–1.0), which was equivalent to the reference population (0.902,
p
= 0.523). The vast majority of patients experienced ‘no problems’ or ‘slight problems’ in any of the EQ-5D-5L dimensions. The complication rate associated with rib fracture fixation was low, implant-related irritation was the most common long-term sequela and occurred in 31% of patients. In multivariable regression analyses, total length of stay on the intensive care unit (ICU-LOS) was independently associated with a worse quality of life.
Conclusions
Patients who underwent rib fracture fixation for multiple rib fractures or flail chest after severe chest trauma experienced a good quality of life at least 1 year after surgery. A longer ICU-LOS was independently associated with impaired quality of life. In addition, there were no significant differences in the long-term quality of life and functional outcome between patients with multiple rib fractures and a flail chest. Implant-related irritation was the most important long-term sequela and occurred in one-third of patients.</description><subject>Adult</subject><subject>Critical Care Medicine</subject><subject>Dyspnea</subject><subject>Emergency medical care</subject><subject>Emergency Medicine</subject><subject>Fracture Fixation</subject><subject>Fracture Fixation, Internal</subject><subject>Fractures</subject><subject>Humans</subject><subject>Intensive</subject><subject>Length of Stay</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Quality of Life</subject><subject>Questionnaires</subject><subject>Retrospective Studies</subject><subject>Rib cage</subject><subject>Rib Fractures - surgery</subject><subject>Ribs</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Trauma</subject><subject>Traumatic Surgery</subject><issn>1863-9933</issn><issn>1863-9941</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp90MtKxDAUBuAgiuPtBVxIwI2bam5N2qWINxhwo-uQJidDh7aZSVrQtzfj6AguXCUk3_lDfoTOKbmmhKibRAiRVUEYKQgVihRyDx3RSvKirgXd3-05n6HjlJZZE1myQzTjrFJSKXaE5vMwLIoRYo_Xk-na8QMHj7vWAzaDw34a7NiGwXQ4TKMNfT72WePYNthHY8cpAvbtu9moU3TgTZfg7Hs9QW8P9693T8X85fH57nZeWK7KsSitc0Y61zTAHAVfN9TWypdGQi1cBSUXQhoBxilqoAJpheWmYbJmlRBK8BN0tc1dxbCeII26b5OFrjMDhClpJngtOSsrlenlH7oMU8z_yUoyKWQpqMyKbZWNIaUIXq9i25v4oSnRm671tmudu9ZfXevN0MV39NT04HYjP-VmwLcg5athAfH37X9iPwH_hooH</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>Peek, Jesse</creator><creator>Kremo, Valerie</creator><creator>Beks, Reinier</creator><creator>van Veelen, Nicole</creator><creator>Leiser, Alfred</creator><creator>Link, Björn-Christian</creator><creator>Houwert, Roderick M.</creator><creator>Minervini, Fabrizio</creator><creator>Knobe, Matthias</creator><creator>Babst, Reto H.</creator><creator>Beeres, Frank J. P.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0667-4076</orcidid></search><sort><creationdate>20220201</creationdate><title>Long-term quality of life and functional outcome after rib fracture fixation</title><author>Peek, Jesse ; Kremo, Valerie ; Beks, Reinier ; van Veelen, Nicole ; Leiser, Alfred ; Link, Björn-Christian ; Houwert, Roderick M. ; Minervini, Fabrizio ; Knobe, Matthias ; Babst, Reto H. ; Beeres, Frank J. P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-5cdda6ddbbe2d1ef9b1c97f5a6e94d8e53446a4ead71ae8e6c4c3ab2692844743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Critical Care Medicine</topic><topic>Dyspnea</topic><topic>Emergency medical care</topic><topic>Emergency Medicine</topic><topic>Fracture Fixation</topic><topic>Fracture Fixation, Internal</topic><topic>Fractures</topic><topic>Humans</topic><topic>Intensive</topic><topic>Length of Stay</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Quality of Life</topic><topic>Questionnaires</topic><topic>Retrospective Studies</topic><topic>Rib cage</topic><topic>Rib Fractures - surgery</topic><topic>Ribs</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Trauma</topic><topic>Traumatic Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peek, Jesse</creatorcontrib><creatorcontrib>Kremo, Valerie</creatorcontrib><creatorcontrib>Beks, Reinier</creatorcontrib><creatorcontrib>van Veelen, Nicole</creatorcontrib><creatorcontrib>Leiser, Alfred</creatorcontrib><creatorcontrib>Link, Björn-Christian</creatorcontrib><creatorcontrib>Houwert, Roderick M.</creatorcontrib><creatorcontrib>Minervini, Fabrizio</creatorcontrib><creatorcontrib>Knobe, Matthias</creatorcontrib><creatorcontrib>Babst, Reto H.</creatorcontrib><creatorcontrib>Beeres, Frank J. P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peek, Jesse</au><au>Kremo, Valerie</au><au>Beks, Reinier</au><au>van Veelen, Nicole</au><au>Leiser, Alfred</au><au>Link, Björn-Christian</au><au>Houwert, Roderick M.</au><au>Minervini, Fabrizio</au><au>Knobe, Matthias</au><au>Babst, Reto H.</au><au>Beeres, Frank J. P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term quality of life and functional outcome after rib fracture fixation</atitle><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle><stitle>Eur J Trauma Emerg Surg</stitle><addtitle>Eur J Trauma Emerg Surg</addtitle><date>2022-02-01</date><risdate>2022</risdate><volume>48</volume><issue>1</issue><spage>255</spage><epage>264</epage><pages>255-264</pages><issn>1863-9933</issn><eissn>1863-9941</eissn><abstract>Purpose
The primary aim of this study was to assess the long-term quality of life and functional outcome after rib fracture fixation for patients with multiple rib fractures or flail chest. Secondarily, this study sought to identify risk factors associated with the quality of life.
Methods
A retrospective cohort study with a follow-up by questionnaire was performed at a level-1 trauma center in Switzerland. All adult patients with three or more rib fractures treated with rib fixation between 2010 and 2018 were eligible for inclusion. All outcomes were independently assessed for patients with multiple rib fractures and patients with a flail chest. The outcome measures were quality of life, level of dyspnea, return to work, implant irritation, and implant removal after a minimum of 12 months of follow-up. Quality of life was assessed using the EuroQol five-dimensional five-level questionnaire (EQ-5D-5L) and level of dyspnea was determined with the modified Medical Research Council dyspnea (mMRC) scale.
Results
The survey was completed by 74 out of 102 patients (73%) at a median follow-up of 26 months (IQR 15–37). The median EQ-5D utility index score was 0.91 (0.89–1.0), which was equivalent to the reference population (0.902,
p
= 0.523). The vast majority of patients experienced ‘no problems’ or ‘slight problems’ in any of the EQ-5D-5L dimensions. The complication rate associated with rib fracture fixation was low, implant-related irritation was the most common long-term sequela and occurred in 31% of patients. In multivariable regression analyses, total length of stay on the intensive care unit (ICU-LOS) was independently associated with a worse quality of life.
Conclusions
Patients who underwent rib fracture fixation for multiple rib fractures or flail chest after severe chest trauma experienced a good quality of life at least 1 year after surgery. A longer ICU-LOS was independently associated with impaired quality of life. In addition, there were no significant differences in the long-term quality of life and functional outcome between patients with multiple rib fractures and a flail chest. Implant-related irritation was the most important long-term sequela and occurred in one-third of patients.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32876772</pmid><doi>10.1007/s00068-020-01470-6</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-0667-4076</orcidid></addata></record> |
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| ispartof | European journal of trauma and emergency surgery (Munich : 2007), 2022-02, Vol.48 (1), p.255-264 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Critical Care Medicine Dyspnea Emergency medical care Emergency Medicine Fracture Fixation Fracture Fixation, Internal Fractures Humans Intensive Length of Stay Medicine Medicine & Public Health Original Article Quality of Life Questionnaires Retrospective Studies Rib cage Rib Fractures - surgery Ribs Sports Medicine Surgery Surgical Orthopedics Trauma Traumatic Surgery |
| title | Long-term quality of life and functional outcome after rib fracture fixation |
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