Boris Kessel1, Jasmin Dagan2, Forat Swaid3, Itamar Ashkenazi2, Oded Olsha4, Kobi Peleg5, Adi Givon5, Ricardo Alfici2. 1. Trauma Unit, Hillel Yaffe Medical Center, Hadera, Israel. 2. Surgical Division, Hillel Yaffe Medical Center, Hadera, Israel. 3. General Surgery Department, Bnai-Zion Medical Center, Haifa, Israel. Electronic address: foratola@gmail.com. 4. Surgery Department, Shaare Zedek Medical Center, Jerusalem, Israel. 5. National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel.
Abstract
BACKGROUND: Rib fractures are considered a marker of exposure to significant traumatic energy. In children, because of high elasticity of the chest wall, higher energy levels are necessary for ribs to fracture. The purpose of this study was to analyze patterns of associated injuries in children as compared with adults, all of whom presented with rib fractures. METHODS: A retrospective cohort study involving blunt trauma patients with rib fractures registered in the National Trauma Registry was conducted. RESULTS: Of 6,995 trauma victims who were found to suffer from rib fractures, 328 were children and 6,627 were adults. Isolated rib fractures without associated injuries occurred in 19 children (5.8%) and 731 adults (11%). More adults had 4 or more fractured ribs compared with children (P < .001). Children suffered from higher rates of associated brain injuries (P = .003), hemothorax/pneumothorax (P = .006), spleen, and liver injury (P < .001). Mortality rate was 5% in both groups. CONCLUSIONS: The incidence of associated head, thoracic, and abdominal solid organ injuries in children was significantly higher than in adults suffering from rib fractures. In spite of a higher Injury Severity Score and incidence of associated injuries, mortality rate was similar. Mortality of rib fracture patients was mostly affected by the presence of extrathoracic injuries.
BACKGROUND: Rib fractures are considered a marker of exposure to significant traumatic energy. In children, because of high elasticity of the chest wall, higher energy levels are necessary for ribs to fracture. The purpose of this study was to analyze patterns of associated injuries in children as compared with adults, all of whom presented with rib fractures. METHODS: A retrospective cohort study involving blunt traumapatients with rib fractures registered in the National Trauma Registry was conducted. RESULTS: Of 6,995 trauma victims who were found to suffer from rib fractures, 328 were children and 6,627 were adults. Isolated rib fractures without associated injuries occurred in 19 children (5.8%) and 731 adults (11%). More adults had 4 or more fractured ribs compared with children (P < .001). Children suffered from higher rates of associated brain injuries (P = .003), hemothorax/pneumothorax (P = .006), spleen, and liver injury (P < .001). Mortality rate was 5% in both groups. CONCLUSIONS: The incidence of associated head, thoracic, and abdominal solid organ injuries in children was significantly higher than in adults suffering from rib fractures. In spite of a higher Injury Severity Score and incidence of associated injuries, mortality rate was similar. Mortality of rib fracturepatients was mostly affected by the presence of extrathoracic injuries.
Authors: Cornelius A Thiels; Johnathon M Aho; Nimesh D Naik; Martin D Zielinski; Henry J Schiller; David S Morris; Brian D Kim Journal: J Trauma Acute Care Surg Date: 2016-05 Impact factor: 3.313
Authors: Ting-Min Hsieh; Tsung-Cheng Tsai; Yueh-Wei Liu; Ching-Hua Hsieh Journal: Int J Environ Res Public Health Date: 2016-07-21 Impact factor: 3.390