Sarah Majercik1, Sathya Vijayakumar2, Griffin Olsen2, Emily Wilson3, Scott Gardner4, Steven R Granger4, Don H Van Boerum4, Thomas W White4. 1. Division of Trauma Services and Surgical Critical Care, Intermountain Medical Center, 5121 South Cottonwood Street, Murray, UT, 84107, USA. Electronic address: sarah.majercik@imail.org. 2. Surgical Services Clinical Program, Intermountain Medical Center, Murray, UT, USA. 3. Division of Pulmonary and Critical Care Medicine, Intermountain Medical Center, Murray, UT, USA. 4. Division of Trauma Services and Surgical Critical Care, Intermountain Medical Center, 5121 South Cottonwood Street, Murray, UT, 84107, USA.
Abstract
BACKGROUND: Retained hemothorax (RH) is relatively common after chest trauma and can lead to empyema. We hypothesized that patients who have surgical fixation of rib fractures (SSRF) have less RH and empyema than those who have medical management of rib fractures (MMRF). METHODS: Admitted rib fracture patients from January 2009 to June 2013 were identified. A 2:1 propensity score model identified MMRF patients who were similar to SSRF. RH, and empyema and readmissions, were recorded. Variables were compared using Fisher exact test and Wilcoxon rank-sum tests. RESULTS: One hundred thirty-seven SSRF and 274 MMRF were analyzed; 31 (7.5%) had RH requiring 35 interventions; 3 (2.2%) SSRF patients had RH compared with 28 (10.2%) MMRF (P = .003). Four (14.3%) MMRF subjects with RH developed empyema versus zero in the SSRF group (P = .008); 6 (19.3%) RH patients required readmission versus 14 (3.7%) in the non-RH group (P = .002). CONCLUSIONS: Patients with rib fractures who have SSRF have less RH compared with similar MMRF patients. Although not a singular reason to perform SSRF, this clinical benefit should not be overlooked.
BACKGROUND: Retained hemothorax (RH) is relatively common after chest trauma and can lead to empyema. We hypothesized that patients who have surgical fixation of rib fractures (SSRF) have less RH and empyema than those who have medical management of rib fractures (MMRF). METHODS: Admitted rib fracturepatients from January 2009 to June 2013 were identified. A 2:1 propensity score model identified MMRF patients who were similar to SSRF. RH, and empyema and readmissions, were recorded. Variables were compared using Fisher exact test and Wilcoxon rank-sum tests. RESULTS: One hundred thirty-seven SSRF and 274 MMRF were analyzed; 31 (7.5%) had RH requiring 35 interventions; 3 (2.2%) SSRF patients had RH compared with 28 (10.2%) MMRF (P = .003). Four (14.3%) MMRF subjects with RH developed empyema versus zero in the SSRF group (P = .008); 6 (19.3%) RH patients required readmission versus 14 (3.7%) in the non-RH group (P = .002). CONCLUSIONS:Patients with rib fractures who have SSRF have less RH compared with similar MMRF patients. Although not a singular reason to perform SSRF, this clinical benefit should not be overlooked.
Authors: Helen Ma Ingoe; Elizabeth Coleman; William Eardley; Amar Rangan; Catherine Hewitt; Catriona McDaid Journal: BMJ Open Date: 2019-04-01 Impact factor: 2.692
Authors: Mathieu M E Wijffels; Jonne T H Prins; Suzanne Polinder; Taco J Blokhuis; Erik R De Loos; Roeland H Den Boer; Elvira R Flikweert; Albert F Pull Ter Gunne; Akkie N Ringburg; W Richard Spanjersberg; Pieter J Van Huijstee; Gust Van Montfort; Jefrey Vermeulen; Dagmar I Vos; Michael H J Verhofstad; Esther M M Van Lieshout Journal: World J Emerg Surg Date: 2019-07-30 Impact factor: 5.469