View in EDS

Surgical Stabilization of Rib Fractures in Geriatric Trauma Patients: A National Trauma Data Bank Review.

Saved in:
Bibliographic Details
Title: Surgical Stabilization of Rib Fractures in Geriatric Trauma Patients: A National Trauma Data Bank Review.
Authors: Plumb, Jared, Topper, Gena V., Metheny, Jacob, Morris, Patrick, Hess, T., Hunter, Krystal, Voytik, Malia, Magura, Connor, Ratnasekera, Asanthi, Egodage, Tanya
Source: Journal of the American Geriatrics Society. Mar2026, Vol. 74 Issue 3, p738-747. 10p.
Subjects: Wounds & injuries, Early medical intervention, T-test (Statistics), Treatment effectiveness, Retrospective studies, Descriptive statistics, Multivariate analysis, Chi-squared test, Mann Whitney U Test, Longitudinal method, Odds ratio, Convalescence, Statistics, Rib fractures, Data analysis software, Confidence intervals, Old age
Abstract: Background: Rib fractures are common and increase mortality in older adult patients. Early surgical stabilization of rib fractures (SSRF), < 72 h from admission, has been shown to improve outcomes in younger patients. We hypothesize that patients ≥ 65 years requiring SSRF will have improved outcomes with early SSRF. Methods: This was a retrospective cohort analysis of patients ≥ 65 years between 1/1/2018 and 12/31/2022 who underwent SSRF and were captured in the National Trauma Data Bank. Patients who died within 24 h were excluded. Demographic and injury characteristics, comorbidities, hospital events and discharge dispositions were captured. Study groups were early (< 72 h) versus late SSRF. Primary outcomes were hospital length of stay (HLOS), intensive care unit LOS (ILOS), duration of mechanical ventilation (DMV), and mortality. With early SSRF as the reference group, multivariable analysis was conducted. Results: Five thousand one hundred twenty‐nine patients met inclusion criteria. Three thousand seventy (59.8%) underwent early SSRF and 2059 (40.1%) underwent late SSRF. Early SSRF was associated with shorter HLOS (9 vs. 14 days), ILOS (6 vs. 9 days), and DMV (5 vs. 9 days) (all p < 0.001). There was no difference in mortality (4.7% vs. 5.3%, p = 0.23). Early fixation was associated with fewer complications including unplanned intubation (6.6% vs. 13.5%), tracheostomy (1.9% vs. 5.3%), acute respiratory distress syndrome (0.9% vs. 1.7%), and pneumonia (0.2% vs. 0.7%) (all p < 0.001). On multivariable analysis, HLOS, ILOS, and DMV increased with late fixation (all p < 0.001). Conclusion: Early SSRF is associated with improved outcomes and fewer complications in older adult patients with rib fractures. Further study will guide treatment protocols for the growing population of older adult trauma patients. Summary: Key points○Early SSRF was associated with shorter hospital and ICU lengths of stay and duration of mechanical ventilation.○Unplanned intubation, return to the operating room, and ICU admission occurred less frequently in the early SSRF group.○The timing of SSRF had more impact on patient outcomes than the severity of chest wall injury.Why does this paper matter?○Current guidelines, including those from the Eastern Association for the Surgery of Trauma (EAST) and the Chest Wall Injury Society (CWIS), recommend performing the surgical stabilization of rib fractures (SSRF) within 72 h of admission for all trauma patients.○This study investigated how the timing of surgical intervention impacted patient outcomes specifically in patients ≥ 65 years of age, finding that early SSRF significantly improves most outcomes, contributing to the limited literature on this practice in the geriatric population. [ABSTRACT FROM AUTHOR]
Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
Description
Abstract:Background: Rib fractures are common and increase mortality in older adult patients. Early surgical stabilization of rib fractures (SSRF), < 72 h from admission, has been shown to improve outcomes in younger patients. We hypothesize that patients ≥ 65 years requiring SSRF will have improved outcomes with early SSRF. Methods: This was a retrospective cohort analysis of patients ≥ 65 years between 1/1/2018 and 12/31/2022 who underwent SSRF and were captured in the National Trauma Data Bank. Patients who died within 24 h were excluded. Demographic and injury characteristics, comorbidities, hospital events and discharge dispositions were captured. Study groups were early (< 72 h) versus late SSRF. Primary outcomes were hospital length of stay (HLOS), intensive care unit LOS (ILOS), duration of mechanical ventilation (DMV), and mortality. With early SSRF as the reference group, multivariable analysis was conducted. Results: Five thousand one hundred twenty‐nine patients met inclusion criteria. Three thousand seventy (59.8%) underwent early SSRF and 2059 (40.1%) underwent late SSRF. Early SSRF was associated with shorter HLOS (9 vs. 14 days), ILOS (6 vs. 9 days), and DMV (5 vs. 9 days) (all p < 0.001). There was no difference in mortality (4.7% vs. 5.3%, p = 0.23). Early fixation was associated with fewer complications including unplanned intubation (6.6% vs. 13.5%), tracheostomy (1.9% vs. 5.3%), acute respiratory distress syndrome (0.9% vs. 1.7%), and pneumonia (0.2% vs. 0.7%) (all p < 0.001). On multivariable analysis, HLOS, ILOS, and DMV increased with late fixation (all p < 0.001). Conclusion: Early SSRF is associated with improved outcomes and fewer complications in older adult patients with rib fractures. Further study will guide treatment protocols for the growing population of older adult trauma patients. Summary: Key points○Early SSRF was associated with shorter hospital and ICU lengths of stay and duration of mechanical ventilation.○Unplanned intubation, return to the operating room, and ICU admission occurred less frequently in the early SSRF group.○The timing of SSRF had more impact on patient outcomes than the severity of chest wall injury.Why does this paper matter?○Current guidelines, including those from the Eastern Association for the Surgery of Trauma (EAST) and the Chest Wall Injury Society (CWIS), recommend performing the surgical stabilization of rib fractures (SSRF) within 72 h of admission for all trauma patients.○This study investigated how the timing of surgical intervention impacted patient outcomes specifically in patients ≥ 65 years of age, finding that early SSRF significantly improves most outcomes, contributing to the limited literature on this practice in the geriatric population. [ABSTRACT FROM AUTHOR]
ISSN:00028614
DOI:10.1111/jgs.70297