Diego Flores-Funes1, Africa Dakota Lluna-Llorens2, Miguel Ángel Jiménez-Ballester3, Graciela Valero-Navarro3, Andrés Carrillo-Alcaráz4,5, Álvaro Campillo-Soto3, José Luis Aguayo-Albasini3. 1. General Surgery Department, JM Morales Meseguer University Hospital, Avenida Marqués de los Vélez, S/N, 30008, Murcia, Spain. diego.ff90@gmail.com. 2. Ortopedics and Traumatology Department, JM Morales Meseguer University Hospital, Murcia, Spain. 3. General Surgery Department, JM Morales Meseguer University Hospital, Avenida Marqués de los Vélez, S/N, 30008, Murcia, Spain. 4. Head of Intensive Care Unit, JM Morales Meseguer University Hospital, Murcia, Spain. 5. Medicine Faculty, University of Murcia, IMIB-Arrixaca, Campus de Excelencia Internacional Mare Nostrum, Murcia, Spain.
Abstract
AIM: To analyse factors that may predict the appearance of rib fracture complications during the first days of evolution and determine whether the number of fractures is related to these complications. METHOD: Retrospective case-control study of patients admitted with a diagnosis of rib fractures between 2010 and 2014. Two groups were established depending on the appearance or not of pleuropulmonary complications in the first 72 h, and the following were compared: age, sex, Charlson comorbidity index (CCI), number and uni- or bilateral involvement, mechanism of trauma, days of hospital stay, haemoglobin on discharge minus haemoglobin on admission, pleuropulmonary complications during admission (pneumothorax, haemothorax or pulmonary contusion) and placement of pleural drainage. RESULTS: One hundred and forty-one cases of rib fractures were admitted in the period mentioned. There were no differences in the patients' baseline characteristics (age, sex and Charlson Comorbidity Index) between the two groups. Differences were found in the number of fractures (2.98 ± 1.19 in the group without complications vs 3.55 ± 1.33 in the group with complications, p = 0.05) and in the drop in the level of haemoglobin (0.52 ± 0.91 mg/dl vs 1.22 ± 1.29 mg/dl, p = 0.01). The length of hospital stay varied considerably in each group (5.35 ± 4.05 days vs 7.86 ± 6.96 days), but without statistical significance (p = 0.11). CONCLUSIONS: The number of fractured ribs that best predicted the appearance of complications (delayed pleuropulmonary complications and greater bleeding) was 3 or more.
AIM: To analyse factors that may predict the appearance of rib fracture complications during the first days of evolution and determine whether the number of fractures is related to these complications. METHOD: Retrospective case-control study of patients admitted with a diagnosis of rib fractures between 2010 and 2014. Two groups were established depending on the appearance or not of pleuropulmonary complications in the first 72 h, and the following were compared: age, sex, Charlson comorbidity index (CCI), number and uni- or bilateral involvement, mechanism of trauma, days of hospital stay, haemoglobin on discharge minus haemoglobin on admission, pleuropulmonary complications during admission (pneumothorax, haemothorax or pulmonary contusion) and placement of pleural drainage. RESULTS: One hundred and forty-one cases of rib fractures were admitted in the period mentioned. There were no differences in the patients' baseline characteristics (age, sex and Charlson Comorbidity Index) between the two groups. Differences were found in the number of fractures (2.98 ± 1.19 in the group without complications vs 3.55 ± 1.33 in the group with complications, p = 0.05) and in the drop in the level of haemoglobin (0.52 ± 0.91 mg/dl vs 1.22 ± 1.29 mg/dl, p = 0.01). The length of hospital stay varied considerably in each group (5.35 ± 4.05 days vs 7.86 ± 6.96 days), but without statistical significance (p = 0.11). CONCLUSIONS: The number of fractured ribs that best predicted the appearance of complications (delayed pleuropulmonary complications and greater bleeding) was 3 or more.
Authors: Katherine W Gonzalez; Mira H Ghneim; Francis Kang; Daniel C Jupiter; Matthew L Davis; Justin L Regner Journal: J Trauma Acute Care Surg Date: 2015-05 Impact factor: 3.313
Authors: John B Holcomb; Neil R McMullin; Rosemary A Kozar; Marjorie H Lygas; Frederick A Moore Journal: J Am Coll Surg Date: 2003-04 Impact factor: 6.113