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Affiliation
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Florida International University, Herbert Wertheim College of Medicine, Department of Surgery, 11200 SW 8 St, Miami, FL 33199 USA. |
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Abstract
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OBJECTIVES: To compare outcomes in patients with rib fractures (RFX) who underwent surgical stabilization of rib fractures (SSRF) to those treated non-operatively.
DESIGN: Retrospective cohort study SETTING:: Two Level 1 Trauma Centers. Florida, USA PATIENTS:: 174 patients with multiple rib fractures divided in 2 groups: Patients with Surgically Stabilized Rib Fractures (n=87) were compared to non-operatively managed patients in the Matched Control Group (n=87). INTERVENTION: Surgical stabilization of rib fractures OUTCOME MEASUREMENTS:: Age, gender, ISS, RFX, mortality, hospital (HLOS) and ICU length of stay (ICULOS), days of mechanical ventilation (DMV), co-injuries, and time to surgery. Patients were further stratified by presence or absence of flail chest and pulmonary contusion.
RESULTS: Flail chest, displaced RFX and pulmonary contusion were present significantly more often in SSRF patients compared to the MCG. Mortality was lower in SSRF group. HLOS and ICULOS were longer in SSRF group compared to the corresponding MCG patients regardless of timing to surgery (p<0.01 for all). SSRF patients with flail chest had comparable HLOS, ICULOS and DMV to MCG patients with flail chest (p>0.3 for all). SSRF patients without flail chest had significantly longer HLOS and ICULOS than MCG patients without flail chest (p<0.001 for both). Presence of pulmonary contusion did not affect lengths of stay.
CONCLUSIONS: SSRF patients had reduced mortality compared to non-operatively managed patients. HLOS, ICULOS and DMV were longer in SSRF patients than in MCG. When flail chest was present, lengths of stay were comparable. Pulmonary contusion did not appear to affect the surgical outcome. LEVEL OF EVIDENCE: Therapeutic Level III.
Language: en |