Francis Ali-Osman1, Alicia Mangram2, Joseph Sucher3, Gina Shirah4, Van Johnson5, Phillip Moeser6, Natasha K Sinchuk7, James K Dzandu8. 1. HonorHealth John C. Lincoln Medical Center, USA. Electronic address: Francis.Ali-OsmanMD@honorhealth.com. 2. HonorHealth John C. Lincoln Medical Center, USA. Electronic address: Alicia.Mangram@honorhealth.com. 3. HonorHealth Deer Valley Medical Center, USA. Electronic address: Joseph.SucherMD@honorhealth.com. 4. HonorHealth John C. Lincoln Medical Center, USA. Electronic address: Gina.Shirah@honorhealth.com. 5. HonorHealth John C. Lincoln Medical Center, USA. Electronic address: VanJohnson@honorhealth.com. 6. HonorHealth John C. Lincoln Medical Center, USA. Electronic address: pmoeser@mdig-Itd.com. 7. HonorHealth John C. Lincoln Medical Center, USA. Electronic address: Natasha.sinchuk@honorhealth.com. 8. HonorHealth John C. Lincoln Medical Center, USA. Electronic address: james.dzandu@honorhealth.com.
Abstract
BACKGROUND: Patient outcomes after muscle sparing minimally invasive thoracotomy rib fixation (MSMIT-ORF) in geriatric G60 trauma patients remain poorly studied. This study determined the effect of MSMIT-ORF on pulmonary function (PFT). Non-operatively managed (NOM) patients were also described. METHODS: Medical records of G60 patients with severe rib fractures with PFTs measured before and after MSMIT-ORF were examined. Patient outcomes (MSMIT-ORF vs NOM) were adjusted in a multivariate logistic regression model. RESULTS: 64 patients underwent MSMIT-ORF, 135 were NOM patients. MSMIT-ORF treated patients showed improvements in PFTs on postoperative day 5, p = 0.001. After adjustment analysis, MSMIT-ORF was associated with increased hospital length of stay (OR 44.9; 95% CI, 9.8-205, p < 0.001), but a more favorable discharge disposition. There was no difference in the rates of pneumonia (p = 0.996) or death (p = 0.140). CONCLUSIONS: MSMIT-ORF is safe and improves pulmonary function in G60 trauma patients diagnosed with severe rib fractures. Future randomized control studies are needed for confirmation.
BACKGROUND:Patient outcomes after muscle sparing minimally invasive thoracotomy rib fixation (MSMIT-ORF) in geriatric G60 traumapatients remain poorly studied. This study determined the effect of MSMIT-ORF on pulmonary function (PFT). Non-operatively managed (NOM) patients were also described. METHODS: Medical records of G60 patients with severe rib fractures with PFTs measured before and after MSMIT-ORF were examined. Patient outcomes (MSMIT-ORF vs NOM) were adjusted in a multivariate logistic regression model. RESULTS: 64 patients underwent MSMIT-ORF, 135 were NOM patients. MSMIT-ORF treated patients showed improvements in PFTs on postoperative day 5, p = 0.001. After adjustment analysis, MSMIT-ORF was associated with increased hospital length of stay (OR 44.9; 95% CI, 9.8-205, p < 0.001), but a more favorable discharge disposition. There was no difference in the rates of pneumonia (p = 0.996) or death (p = 0.140). CONCLUSIONS: MSMIT-ORF is safe and improves pulmonary function in G60 traumapatients diagnosed with severe rib fractures. Future randomized control studies are needed for confirmation.