BACKGROUND: We initiated a multidisciplinary clinical pathway targeting patients greater than 45 years of age with more than 4 rib fractures. The purpose of the current study was to evaluate the effect of this pathway on infectious morbidity and mortality. METHODS: This was a prospective cohort study. Data evaluated included patient demographics, injury characteristics, pain management details, lengths of stay, morbidity, and mortality. Univariate and multivariate analyses were performed using a significance level of P < .05. RESULTS: When adjusting for age, injury severity score, and number of rib fractures, the clinical pathway was associated with decreased intensive care unit length of stay by 2.4 days (95% confidence interval [CI] -4.3, -0.52 days, P = .01) hospital length of stay by 3.7 days (95% CI -7.1, -0.42 days, P = .02), pneumonias (odds ratio [OR] 0.12, 95% CI 0.04 to 0.34, P < .001), and mortality (OR 0.37, 95% CI 0.13 to 1.03, P = .06). CONCLUSIONS: Implementation of a rib fracture multidisciplinary clinical pathway decreased mechanical ventilator-dependent days, lengths of stay, infectious morbidity, and mortality.
BACKGROUND: We initiated a multidisciplinary clinical pathway targeting patients greater than 45 years of age with more than 4 rib fractures. The purpose of the current study was to evaluate the effect of this pathway on infectious morbidity and mortality. METHODS: This was a prospective cohort study. Data evaluated included patient demographics, injury characteristics, pain management details, lengths of stay, morbidity, and mortality. Univariate and multivariate analyses were performed using a significance level of P < .05. RESULTS: When adjusting for age, injury severity score, and number of rib fractures, the clinical pathway was associated with decreased intensive care unit length of stay by 2.4 days (95% confidence interval [CI] -4.3, -0.52 days, P = .01) hospital length of stay by 3.7 days (95% CI -7.1, -0.42 days, P = .02), pneumonias (odds ratio [OR] 0.12, 95% CI 0.04 to 0.34, P < .001), and mortality (OR 0.37, 95% CI 0.13 to 1.03, P = .06). CONCLUSIONS: Implementation of a rib fracture multidisciplinary clinical pathway decreased mechanical ventilator-dependent days, lengths of stay, infectious morbidity, and mortality.
Authors: Sasha D Adams; Bryan A Cotton; Mary F McGuire; Edmundo Dipasupil; Jeanette M Podbielski; Adrian Zaharia; Drue N Ware; Brijesh S Gill; Rondel Albarado; Rosemary A Kozar; James R Duke; Philip R Adams; Carmel B Dyer; John B Holcomb Journal: J Trauma Acute Care Surg Date: 2012-01 Impact factor: 3.313
Authors: Rosemary A Kozar; Saman Arbabi; Deborah M Stein; Steven R Shackford; Robert D Barraco; Walter L Biffl; Karen J Brasel; Zara Cooper; Samir M Fakhry; David Livingston; Frederick Moore; Fred Luchette Journal: J Trauma Acute Care Surg Date: 2015-06 Impact factor: 3.313
Authors: AlleaBelle Gongola; Jace C Bradshaw; Jing Jin; Hanna K Jensen; Avi Bhavaraju; Joseph Margolick; Kevin W Sexton; Ronald Robertson; Kyle J Kalkwarf Journal: Trauma Surg Acute Care Open Date: 2021-06-15