Outcomes after rib fractures in geriatric blunt trauma patients - 13/06/18
Abstract |
Introduction |
Rib fractures after blunt trauma contribute substantially to morbidity and mortality in the elderly.
Methods |
Retrospective review of 255 patients ≥65 years old at a level 2 trauma center over 6 years, who sustained blunt trauma resulting in rib fractures. Outcomes measured include mortality, hospital length of stay(LOS), intensive care unit(ICU) admission, ICU LOS, need for MV, and MV days.
Results |
There were 24 deaths (9.4%), of which 7 were early (<24 h). 130 patients (51%) were admitted to ICU, and 49 (19.2%) required MV. Mean ICU and MV days were 5.9 and 6.3, respectively. ICU admission was predicted by a base deficit <-2.0, ISS>15, bilateral rib fractures, pneumothorax or hemothorax on chest x-ray (All p < 0.001), as well as hypotension, GCS<15, and 1st rib fractures (All p < 0.05). Mortality was predicted by a base deficit < -5.0, GCS score of 3(Both p < 0.001), as well as hypotension, ISS≥25, RTS <7.0, bilateral pneumothoraces, 1st rib fractures, and >5 rib fractures (All p < 0.05).
Conclusion |
Rib fractures in elderly blunt trauma patients are associated with significant mortality and morbidity, but outcomes can be predicted to improve care.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Retrospective review of 255 geriatric patients who sustained traumatic rib fractures. |
• | The overall mortality rate in our study was 9.4%. |
• | There was a relatively linear increase in mortality with the number of rib fractures. |
• | Increasing age did not independently affect mortality, but increased length-of-stay. |
• | Factors were identified which predicted ICU admission, length-of-stay and mortality. |
Plan
Vol 215 - N° 6
P. 1020-1023 - juin 2018 Retour au numéro
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