- Title
- Nonoperative treatment of multiple rib fractures, the results to beat: International multicenter prospective cohort study among 845 patients
- Creator
- Peuker, Felix; Hoepelman, Ruben J.; Minervini, Fabrizio; van Veelen, Nicole M.; Hoogendoorn, Jochem M.; de Jong, Mirjam B.; van Baal, Mark C. P. M.; Leenen, Luke P. H.; Groenwold, Rolf H. H.; Houwert, R. Marijn; Beeres, Frank J. P.; Balogh, Zsolt J.; Beks, Reinier B.; Sweet, Arthur A. R.; IJpma, Frank F. A.; Lansink, Koen W. W.; van Wageningen, Bas; Tromp, Tjarda N.
- Relation
- The Journal of Trauma and Acute Care Surgery Vol. 96, Issue 5, p. 769-776
- Publisher Link
- http://dx.doi.org/10.1097/TA.0000000000004183
- Publisher
- Lippincott Williams & Wilkins
- Resource Type
- journal article
- Date
- 2024
- Description
- Background: Optimal treatment (i.e. nonoperative or operative) for patients with multiple rib fractures remains debated. Studies that compare treatments are rationalized by the alleged poor outcomes of nonoperative treatment. Methods: The aim of this prospective international multicenter cohort study (between January 2018 and March 2021) with one-year follow-up, was to report contemporary outcomes of nonoperatively treated patients with multiple rib fractures. Including 845 patients with three or more rib fractures. Primary outcome was in-hospital mortality. Secondary outcomes included hospital length of stay (HLOS), (pulmonary) complications, and quality of life. Results: Mean age was 57.7 ± 17.0 years, median Injury Severity Score was 17 (13-22) and the median number of rib fractures was 6 (4-8). In-hospital mortality rate was 1.5% (n = 13), 112 (13.3%) patients had pneumonia and four (0.5%) patients developed a symptomatic nonunion. The median HLOS was 7 (4-13) days, and median intensive care unit length of stay was 2 (1-5) days. Mean 5-Level Quality of Life Questionnaire index value was 0.83 ± 0.18 1 year after trauma. Polytrauma patients had a median HLOS of 10 (6-18) days, a pneumonia rate of 17.6% (n = 77) and mortality rate of 1.7% (n = 7). Elderly patients (≥65 years) had a median HLOS of 9 (5-15) days, a pneumonia rate of 19.7% (n = 57) and mortality rate of 4.1% (n = 12). Conclusion: Overall, nonoperative treatment of patients with multiple rib fractures shows low mortality and morbidity rate and good quality of life after 1 year. Future studies evaluating the benefit of operative stabilisation should use contemporary outcomes to establish the therapeutic margin of rib fixation. Level of evidence: Therapeutic/Care Management; Level III.
- Subject
- multiple rib fractures; conservative treatment; nonoperative treatment; quality of life; mortality; pneumonia rate; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1503785
- Identifier
- uon:55398
- Identifier
- ISSN:2163-0755
- Language
- eng
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