Factors associated with discharge to home after traumatic rib fractures.

Injury Pub Date : 2025-05-05 DOI:10.1016/j.injury.2025.112351

Jennifer M Brewer, Julia R Silverman, Yuen-Joyce Liu, Jeremy Fridling, Evert A Eriksson, S M Leon, Ysela Carrillo, Mark McMellen, Robin Chappell, Alison Schultz, Brian C Thurston, Zachary M Bauman, Alexandra A Myers, Joseph D Forrester, Carol McGuiness, Ronald Gross, T Russel Hill, Chasen Greig, Manuel Moutinho, Andrew R Doben

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Abstract

Background: Chest wall injury is common among trauma patients. Generally, patients with more medical problems tend to have worse outcomes with rib fractures. Our aim was to determine if surgical stabilization of rib fractures (SSRF) increases the likelihood of discharge to home.

Methods: We performed a retrospective cohort study of patients with ≥1 comorbidity, aged 18-99 with rib fractures from five Chest Wall Injury Society (CWIS) Collaborative Centers. Discharge disposition of patients who underwent SSRF was compared to those who did not undergo surgery. Discharge to home was considered the ideal state to which other discharge dispositions were compared. For the model to estimate discharge to a rehabilitation hospital or skilled nursing facility, a multivariable logistic regression analysis was performed.

Results: 790 patients with ≥1 comorbidities and rib fractures were identified, and 545 (61.8 %) patients were discharged to home. Logistic regression analysis demonstrated SSRF (0.33 (0.15 - 0.75)) and tobacco use (0.62 (0.39 - 0.96)) were independently associated with discharge to home.

Conclusion: In patients with rib fractures and at least one comorbid condition, SSRF is associated with discharge to home. Counterintuitively, tobacco use was also associated with discharge to home.

Level of evidence: Level II STUDY TYPE: Therapeutic/Care Management.

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外伤性肋骨骨折后出院的相关因素。

背景：胸壁损伤在创伤患者中很常见。一般来说，有更多医疗问题的患者往往会有更糟糕的肋骨骨折结果。我们的目的是确定手术稳定肋骨骨折（SSRF）是否会增加出院回家的可能性。方法：我们对来自5个胸壁损伤学会（CWIS）合作中心的年龄在18-99岁、共病≥1例的肋骨骨折患者进行了回顾性队列研究。将接受SSRF治疗的患者与未接受手术治疗的患者进行比较。出院回家被认为是理想状态，与其他出院处置比较。为了估计康复医院或专业护理机构的出院情况，模型进行了多变量logistic回归分析。结果：790例患者合并症及肋骨骨折≥1例，545例（61.8%）患者出院回家。Logistic回归分析显示，SSRF（0.33(0.15 - 0.75)）和烟草使用（0.62(0.39 - 0.96)）与出院回家独立相关。结论：在肋骨骨折且至少有一种合并症的患者中，SSRF与出院有关。与直觉相反的是，吸烟也与回家有关。证据等级：二级研究类型：治疗/护理管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Injury

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