Joanna Wycech1,2, Alexander Alexei Fokin3, Ivan Puente1,2,4,5. 1. Division of Trauma and Critical Care Services, Delray Medical Center, 5352 Linton Boulevard, Delray Beach, FL, 33484, USA. 2. Division of Trauma and Critical Care Services, Broward Health Medical Center, 1600 S Andrews Ave, Fort Lauderdale, FL, 33316, USA. 3. Division of Trauma and Critical Care Services, Delray Medical Center, 5352 Linton Boulevard, Delray Beach, FL, 33484, USA. Alexander.Fokin@tenethealth.com. 4. Department of Surgery, Charles E. Schmidt College of Medicine, Florida Atlantic University, 777 Glades Rd, Boca Raton, FL, 33431, USA. 5. Department of Surgery, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA.
Abstract
PURPOSE: Surgical Stabilization (SSRF) is gaining popularity as an alternative to non-operative management (NOM) of patients with rib fractures, however, there are no established guidelines for patients' quantifiable evaluation and for SSRF recommendation. Known rib scoring systems include: Rib Fracture Score (RFS), Chest Wall Trauma Score (CWTS), Chest Trauma Score (CTS) and RibScore (RS), but are underutilized. The purpose was to provide values of scoring systems in SSRF and NOM patients and correlate them with treatment assignment. METHODS: Retrospective cohort study included 87 SSRF and 87 propensity matched NOM patients from two level-1 trauma centers. Clinical variables and score values were compared between two groups. RESULTS: SSRF compared to NOM patients had significantly higher number of total rib fractures, displaced fractures, rates of pulmonary contusion and flail chest. RS and CTS values were significantly higher in SSRF compared to NOM patients (2.3 vs. 1.7, p = 0.001; 5.8 vs. 5.3, p = 0.005, respectively), but RFS and CWTS were similar. CONCLUSIONS: Application of scoring systems could help with patients' objective and standardized assessment and may aid in treatment decisions. RibScore was superior to other scoring systems.
PURPOSE: Surgical Stabilization (SSRF) is gaining popularity as an alternative to non-operative management (NOM) of patients with rib fractures, however, there are no established guidelines for patients' quantifiable evaluation and for SSRF recommendation. Known rib scoring systems include: Rib Fracture Score (RFS), Chest Wall Trauma Score (CWTS), Chest Trauma Score (CTS) and RibScore (RS), but are underutilized. The purpose was to provide values of scoring systems in SSRF and NOM patients and correlate them with treatment assignment. METHODS: Retrospective cohort study included 87 SSRF and 87 propensity matched NOM patients from two level-1 trauma centers. Clinical variables and score values were compared between two groups. RESULTS: SSRF compared to NOM patients had significantly higher number of total rib fractures, displaced fractures, rates of pulmonary contusion and flail chest. RS and CTS values were significantly higher in SSRF compared to NOM patients (2.3 vs. 1.7, p = 0.001; 5.8 vs. 5.3, p = 0.005, respectively), but RFS and CWTS were similar. CONCLUSIONS: Application of scoring systems could help with patients' objective and standardized assessment and may aid in treatment decisions. RibScore was superior to other scoring systems.
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