Rahman Barry1, Errington Thompson2. 1. Department of Surgery, Marshall University, Huntington, WV, USA. Electronic address: rahmanbarry@gmail.com. 2. Department of Surgery, Marshall University, Huntington, WV, USA.
Abstract
INTRODUCTION: Rib fractures after blunt trauma contribute substantially to morbidity and mortality in the elderly. METHODS: Retrospective review of 255 patients ≥65 years old at a level 2 trauma center over 6 years, who sustained blunt trauma resulting in rib fractures. Outcomes measured include mortality, hospital length of stay(LOS), intensive care unit(ICU) admission, ICU LOS, need for MV, and MV days. RESULTS: There were 24 deaths (9.4%), of which 7 were early (<24 h). 130 patients (51%) were admitted to ICU, and 49 (19.2%) required MV. Mean ICU and MV days were 5.9 and 6.3, respectively. ICU admission was predicted by a base deficit <-2.0, ISS>15, bilateral rib fractures, pneumothorax or hemothorax on chest x-ray (All p < 0.001), as well as hypotension, GCS<15, and 1st rib fractures (All p < 0.05). Mortality was predicted by a base deficit < -5.0, GCS score of 3(Both p < 0.001), as well as hypotension, ISS≥25, RTS <7.0, bilateral pneumothoraces, 1st rib fractures, and >5 rib fractures (All p < 0.05). CONCLUSION: Rib fractures in elderly blunt trauma patients are associated with significant mortality and morbidity, but outcomes can be predicted to improve care.
INTRODUCTION: Rib fractures after blunt trauma contribute substantially to morbidity and mortality in the elderly. METHODS: Retrospective review of 255 patients ≥65 years old at a level 2 trauma center over 6 years, who sustained blunt trauma resulting in rib fractures. Outcomes measured include mortality, hospital length of stay(LOS), intensive care unit(ICU) admission, ICU LOS, need for MV, and MV days. RESULTS: There were 24 deaths (9.4%), of which 7 were early (<24 h). 130 patients (51%) were admitted to ICU, and 49 (19.2%) required MV. Mean ICU and MV days were 5.9 and 6.3, respectively. ICU admission was predicted by a base deficit <-2.0, ISS>15, bilateral rib fractures, pneumothorax or hemothorax on chest x-ray (All p < 0.001), as well as hypotension, GCS<15, and 1st rib fractures (All p < 0.05). Mortality was predicted by a base deficit < -5.0, GCS score of 3(Both p < 0.001), as well as hypotension, ISS≥25, RTS <7.0, bilateral pneumothoraces, 1st rib fractures, and >5 rib fractures (All p < 0.05). CONCLUSION: Rib fractures in elderly blunt traumapatients are associated with significant mortality and morbidity, but outcomes can be predicted to improve care.
Authors: Ties L Janssen; Elmand Hosseinzoi; Dagmar I Vos; Eelco J Veen; Paul G H Mulder; Adrianus M van der Holst; Lijckle van der Laan Journal: BMC Emerg Med Date: 2019-06-13