Isolated Thoracic Injury Patients With Rib Fractures Undergoing Rib Fixation Have Improved Mortality
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 fra...
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| Veröffentlicht in: | The Journal of surgical research 2021-06, Vol.262, p.197-202 |
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| creator | Yeates, Eric O. Grigorian, Areg Nahmias, Jeffry Dolich, Matthew Lekawa, Michael Qazi, Alliya Kong, Allen Schubl, Sebastian D. |
| description | 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 grade>1 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 |
| doi_str_mv | 10.1016/j.jss.2021.01.016 |
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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 grade>1 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.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2021.01.016</identifier><identifier>PMID: 33607414</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Isolated ; Rib fixation ; Rib fractures ; Surgical stabilization of rib fractures ; Thoracic injury ; Thoracic trauma</subject><ispartof>The Journal of surgical research, 2021-06, Vol.262, p.197-202</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-650e764eebbf468d264d896936cbc5650f9ab87a0464993bf6d69bb614799ea83</citedby><cites>FETCH-LOGICAL-c353t-650e764eebbf468d264d896936cbc5650f9ab87a0464993bf6d69bb614799ea83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jss.2021.01.016$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33607414$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yeates, Eric O.</creatorcontrib><creatorcontrib>Grigorian, Areg</creatorcontrib><creatorcontrib>Nahmias, Jeffry</creatorcontrib><creatorcontrib>Dolich, Matthew</creatorcontrib><creatorcontrib>Lekawa, Michael</creatorcontrib><creatorcontrib>Qazi, Alliya</creatorcontrib><creatorcontrib>Kong, Allen</creatorcontrib><creatorcontrib>Schubl, Sebastian D.</creatorcontrib><title>Isolated Thoracic Injury Patients With Rib Fractures Undergoing Rib Fixation Have Improved Mortality</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>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 grade>1 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.</description><subject>Isolated</subject><subject>Rib fixation</subject><subject>Rib fractures</subject><subject>Surgical stabilization of rib fractures</subject><subject>Thoracic injury</subject><subject>Thoracic trauma</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kM1qGzEURkVpqJ2kD9BN0bKbcaSRrBnRVTFNY0hICAldCv3ciTWMR66kMfXbV8ZploELQnznfkgHoS-ULCih4qpf9CktalLTBTmO-IDmlMhl1YqGfURzQuq64i3hM3SeUk_KXTbsE5oxJkjDKZ8jt05h0BkcftqEqK23eD32UzzgB509jDnh3z5v8KM3-LrkeYqQ8PPoIL4EP76cAv-3wGHEN3oPeL3dxbAvjXchZj34fLhEZ50eEnx-PS_Q8_XPp9VNdXv_a736cVtZtmS5EksCjeAAxnRctK4W3LVSSCasscuSdlKbttGECy4lM51wQhojKG-kBN2yC_Tt1Fse8GeClNXWJwvDoEcIU1I1l1RywSgpKD2hNoaUInRqF_1Wx4OiRB3lql4VueooV5HjiLLz9bV-Mltwbxv_bRbg-wmA8sm9h6iSLQ4tOB_BZuWCf6f-H4DZinc</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Yeates, Eric O.</creator><creator>Grigorian, Areg</creator><creator>Nahmias, Jeffry</creator><creator>Dolich, Matthew</creator><creator>Lekawa, Michael</creator><creator>Qazi, Alliya</creator><creator>Kong, Allen</creator><creator>Schubl, Sebastian D.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202106</creationdate><title>Isolated Thoracic Injury Patients With Rib Fractures Undergoing Rib Fixation Have Improved Mortality</title><author>Yeates, Eric O. ; Grigorian, Areg ; Nahmias, Jeffry ; Dolich, Matthew ; Lekawa, Michael ; Qazi, Alliya ; Kong, Allen ; Schubl, Sebastian D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-650e764eebbf468d264d896936cbc5650f9ab87a0464993bf6d69bb614799ea83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Isolated</topic><topic>Rib fixation</topic><topic>Rib fractures</topic><topic>Surgical stabilization of rib fractures</topic><topic>Thoracic injury</topic><topic>Thoracic trauma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yeates, Eric O.</creatorcontrib><creatorcontrib>Grigorian, Areg</creatorcontrib><creatorcontrib>Nahmias, Jeffry</creatorcontrib><creatorcontrib>Dolich, Matthew</creatorcontrib><creatorcontrib>Lekawa, Michael</creatorcontrib><creatorcontrib>Qazi, Alliya</creatorcontrib><creatorcontrib>Kong, Allen</creatorcontrib><creatorcontrib>Schubl, Sebastian D.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yeates, Eric O.</au><au>Grigorian, Areg</au><au>Nahmias, Jeffry</au><au>Dolich, Matthew</au><au>Lekawa, Michael</au><au>Qazi, Alliya</au><au>Kong, Allen</au><au>Schubl, Sebastian D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Isolated Thoracic Injury Patients With Rib Fractures Undergoing Rib Fixation Have Improved Mortality</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2021-06</date><risdate>2021</risdate><volume>262</volume><spage>197</spage><epage>202</epage><pages>197-202</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><abstract>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 grade>1 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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33607414</pmid><doi>10.1016/j.jss.2021.01.016</doi><tpages>6</tpages></addata></record> |
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| subjects | Isolated Rib fixation Rib fractures Surgical stabilization of rib fractures Thoracic injury Thoracic trauma |
| title | Isolated Thoracic Injury Patients With Rib Fractures Undergoing Rib Fixation Have Improved Mortality |
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