Skip to main content
Erschienen in: European Journal of Trauma and Emergency Surgery 6/2013

01.12.2013 | Original Article

Clinical outcomes of multiple rib fractures: does age matter?

verfasst von: H. Abdulrahman, I. Afifi, A. El-Menyar, A. Al-Hassani, A. Almadani, H. Al-Thani, R. Latifi

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 6/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the clinical outcomes of multiple rib fracture due to blunt trauma in young patients, a 3-year retrospective study was conducted. Patients with ≥3 rib fractures were divided into two groups (group I: <45 years old and group II: ≥45 years old). Mortality, hospital stay, ventilatory support, chest tubes insertion and associated injuries were studied.

Results

Of the 902 patients admitted with blunt chest trauma, 240 (27 %) met the inclusion criteria and 72.5 % patients were <45 years old. The most common causes of injury were motor vehicle crash (59 %) and fall (29 %). The Injury Severity Score (ISS) was higher in group I (16 ± 9 vs. 13 ± 6; p = 0.04). Hospital mortality was higher in group II (6 vs. 2 %; p = 0.18). Pneumothorax, haemothorax and ventilatory support were comparable. Patients in group II were more likely to undergo chest tubes insertion (26 vs. 14 %; p = 0.04), while group I had a significantly higher incidence of associated abdominal injuries (25 vs. 12 %; p = 0.03).

Conclusion

Old age presenting with rib fractures is associated with higher mortality in comparison to young age; however, this difference becomes statistically insignificant in the presence of multiple rib fracture.
Literatur
1.
Zurück zum Zitat Ziegler DW, Agarwal NN. The morbidity and mortality of rib fractures. J Trauma. 1994;37:975–9.PubMedCrossRef Ziegler DW, Agarwal NN. The morbidity and mortality of rib fractures. J Trauma. 1994;37:975–9.PubMedCrossRef
2.
Zurück zum Zitat Bulger EM, Arneson MA, Mock CN, Jurkovich GJ. Rib fractures in the elderly. J Trauma. 2000;48:1040–6.PubMedCrossRef Bulger EM, Arneson MA, Mock CN, Jurkovich GJ. Rib fractures in the elderly. J Trauma. 2000;48:1040–6.PubMedCrossRef
3.
Zurück zum Zitat Bergeron E, Lavoie A, Clas D, et al. Elderly trauma patients with rib fractures are at greater risk of death and pneumonia. J Trauma. 2003;54(3):478–85.PubMedCrossRef Bergeron E, Lavoie A, Clas D, et al. Elderly trauma patients with rib fractures are at greater risk of death and pneumonia. J Trauma. 2003;54(3):478–85.PubMedCrossRef
4.
Zurück zum Zitat Al-Hassani A, Abdulrahman H, Afifi I, et al. Rib fracture patterns predict thoracic chest wall and abdominal solid organ injury. Am Surg. 2010;76(8):888–91.PubMed Al-Hassani A, Abdulrahman H, Afifi I, et al. Rib fracture patterns predict thoracic chest wall and abdominal solid organ injury. Am Surg. 2010;76(8):888–91.PubMed
5.
Zurück zum Zitat Shorr RM, Rodriguez A, Indeck MC, et al. Blunt chest trauma in the elderly. J Trauma. 1989;29(2):234–7. Shorr RM, Rodriguez A, Indeck MC, et al. Blunt chest trauma in the elderly. J Trauma. 1989;29(2):234–7.
6.
Zurück zum Zitat Shweiki E, Klena J, Wood GC, Indeck M. Assessing the true risk of abdominal solid organ injury in hospitalized rib fracture patients. J Trauma. 2001;50(4):684–8.PubMedCrossRef Shweiki E, Klena J, Wood GC, Indeck M. Assessing the true risk of abdominal solid organ injury in hospitalized rib fracture patients. J Trauma. 2001;50(4):684–8.PubMedCrossRef
7.
Zurück zum Zitat Lee RB, Bass SM, Morris JA Jr, MacKenzie EJ. Three or more rib fractures as an indicator for transfer to a Level I trauma center: a population-based study. J Trauma. 1990;30(6):689–94.PubMedCrossRef Lee RB, Bass SM, Morris JA Jr, MacKenzie EJ. Three or more rib fractures as an indicator for transfer to a Level I trauma center: a population-based study. J Trauma. 1990;30(6):689–94.PubMedCrossRef
8.
Zurück zum Zitat Flagel BT, Luchette FA, Reed RL, et al. Half-a-dozen ribs: the breakpoint for mortality. Surgery. 2005;138(4):717–23; discussion 723–5.PubMedCrossRef Flagel BT, Luchette FA, Reed RL, et al. Half-a-dozen ribs: the breakpoint for mortality. Surgery. 2005;138(4):717–23; discussion 723–5.PubMedCrossRef
9.
10.
Zurück zum Zitat Demetriades D, Sava J, Alo K, et al. Old age as a criterion for trauma team activation. J Trauma. 2001;51(4):754–6; discussion 756–7.PubMedCrossRef Demetriades D, Sava J, Alo K, et al. Old age as a criterion for trauma team activation. J Trauma. 2001;51(4):754–6; discussion 756–7.PubMedCrossRef
11.
Zurück zum Zitat Kuhne CA, Ruchholtz S, Kaiser GM, et al. Mortality in severely injured elderly trauma patients—when does age become a risk factor? World J Surg. 2005;29:1476–82.PubMedCrossRef Kuhne CA, Ruchholtz S, Kaiser GM, et al. Mortality in severely injured elderly trauma patients—when does age become a risk factor? World J Surg. 2005;29:1476–82.PubMedCrossRef
12.
Zurück zum Zitat Testerman GM. Adverse outcomes in younger rib fracture patients. South Med J. 2006;99(4):335–9.PubMedCrossRef Testerman GM. Adverse outcomes in younger rib fracture patients. South Med J. 2006;99(4):335–9.PubMedCrossRef
13.
Zurück zum Zitat Holcomb JB, McMullin NR, Kozar RA, Lygas MH, Moore FA. Morbidity from rib fractures increases after age 45. J Am Coll Surg. 2003;196(4):549–55.PubMedCrossRef Holcomb JB, McMullin NR, Kozar RA, Lygas MH, Moore FA. Morbidity from rib fractures increases after age 45. J Am Coll Surg. 2003;196(4):549–55.PubMedCrossRef
14.
Zurück zum Zitat Livingston DH, Shogan B, John P, Lavery RF. CT diagnosis of rib fractures and the prediction of acute respiratory failure. J Trauma. 2008;64(4):905–11.PubMedCrossRef Livingston DH, Shogan B, John P, Lavery RF. CT diagnosis of rib fractures and the prediction of acute respiratory failure. J Trauma. 2008;64(4):905–11.PubMedCrossRef
15.
Zurück zum Zitat Sochor MR, Webber P, Bednarski B, Wang SC. 3D CT imaging versus plain X-ray in diagnosis of rib fractures in lateral impact crashes. Annu Proc Assoc Adv Automot Med. 2003;47:617–8. Sochor MR, Webber P, Bednarski B, Wang SC. 3D CT imaging versus plain X-ray in diagnosis of rib fractures in lateral impact crashes. Annu Proc Assoc Adv Automot Med. 2003;47:617–8.
17.
Zurück zum Zitat Sirmali M, Türüt H, Topçu S, et al. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg. 2003;24(1):133–8.PubMedCrossRef Sirmali M, Türüt H, Topçu S, et al. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg. 2003;24(1):133–8.PubMedCrossRef
18.
Zurück zum Zitat Wu CL, Jani ND, Perkins FM, Barquist E. Thoracic epidural analgesia versus intravenous patient-controlled analgesia for the treatment of rib fracture pain after motor vehicle crash. Trauma. 1999;47:564–7.CrossRef Wu CL, Jani ND, Perkins FM, Barquist E. Thoracic epidural analgesia versus intravenous patient-controlled analgesia for the treatment of rib fracture pain after motor vehicle crash. Trauma. 1999;47:564–7.CrossRef
19.
Zurück zum Zitat Easter A. Management of patients with multiple rib fractures. Am J Crit Care. 2001;10:320–7.PubMed Easter A. Management of patients with multiple rib fractures. Am J Crit Care. 2001;10:320–7.PubMed
20.
Zurück zum Zitat Richardson JD. Indications for thoracotomy in thoracic trauma. Curr Surg. 1985;42:361–4.PubMed Richardson JD. Indications for thoracotomy in thoracic trauma. Curr Surg. 1985;42:361–4.PubMed
21.
Zurück zum Zitat Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S. Chest injury due to blunt trauma. Eur J Cardiothorac Surg. 2003;23(3):374–8.PubMedCrossRef Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S. Chest injury due to blunt trauma. Eur J Cardiothorac Surg. 2003;23(3):374–8.PubMedCrossRef
Metadaten
Titel
Clinical outcomes of multiple rib fractures: does age matter?
verfasst von
H. Abdulrahman
I. Afifi
A. El-Menyar
A. Al-Hassani
A. Almadani
H. Al-Thani
R. Latifi
Publikationsdatum
01.12.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 6/2013
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-013-0291-5

Weitere Artikel der Ausgabe 6/2013

European Journal of Trauma and Emergency Surgery 6/2013 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.