A Retrospective Study Examining the Morbidity and Mortality of Rib Fractures

IntroductionBlunt thoracic trauma (BTT) is the third most common form of traumatic injury, of which rib fractures have been reported to be the most common.Various comorbidities increase the risk of complications following injury.This study aims to explore these risk factors that may contribute to the development of these complications. MethodsA retrospective study of patients with BTT was conducted at the University Hospitals of North Midlands, a major trauma centre in England.The primary outcome was rib fracture-related complications, defined as the occurrence of ≥1 of the following: 90-day mortality, pulmonary complications (including infection, pleural effusion and empyema, haemothorax, pneumothorax and pulmonary contusions), ICU admission, or a hospital stay of ≥7 days. ResultsOf 438 included patients, 199 were admitted to hospital.Recorded complications occurred in 163 patients (37.2%), and 41 patients (9.4%) died within 90 days.In adjusted analyses, age >65 years, lower SpO₂ at presentation and pulmonary contusion were associated with 90-day mortality.Age >65 years and lower SpO₂ were also associated with prolonged hospital LOS.Smoking status was not independently associated with complications or 90-day mortality. ConclusionOlder age and lower oxygen saturation at presentation may identify patients at greater risk of adverse outcomes following traumatic rib fractures.Pulmonary contusion was also associated with 90-day mortality, although the estimate was imprecise because of the small number of events.These observational associations should not be interpreted as causal.