Abstract Aim Evaluation of clinical management practices and outcomes in patients with rib fractures at an NHS tertiary care centre, assessing adherence to best practice guidelines and identifying areas for improvement. Methods A retrospective analysis of 53 patients admitted between January and December 2024 with rib fractures (RF). Results 53 patients of which 6(50 years), 21(50-74 years), 26(75 years). Three groups were identified: Isolated RF (56%, n=30), RF with pneumo +/- hemothorax (25%, n=13), and RF in polytrauma (19%, n=10). Mechanisms of injury: mechanical injuries (60%, n=32), road traffic accidents (21%, n=11), alcohol-related injuries (9.5%, n=5), and loss of consciousness (9.5%, n=5). RF were categorized as simple (4%, n=2), multiple (38%, n=20), and complex (58%, n=31). Rib Score was calculated in 47% (n=25), stratifying patients into low (15%, n=8), medium (59%, n=31), high (22%, n=12), and immediate risk (4%, n=2). Pathway adherence was suboptimal: chest physiotherapy (7%), anaesthetic review (49%), and intensive care review (0%), Analgesia ladder followed in 87% (n=46). One patient underwent rib fixation. Complications occurred in 85% (n=45), including hospital-acquired Pneumonia (HAP), Pleural effusion, Atelectasis, and Delirium. Hospital stay was 1 to 34 days (10 ± 9.6), with one death due to HAP. Conclusion Rib Score utilization and pathway adherence are suboptimal, with inconsistent implementation of MDT and interventions. High complication rates highlight the need for improved preventive measures, such as early mobilization and respiratory therapy. Pain management protocols were effective. Standardizing care pathways may reduce complications and optimize outcomes, particularly in high-risk and polytrauma patients.
Qasim et al. (Fri,) studied this question.