Impact of frailty on outcomes after multiple rib fractures and flail chest undergoing surgical stabilization of rib fractures: a propensity score-matched analysis of the Nationwide Inpatient Sample 2005–2020

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-08-12 DOI:10.1016/j.amjsurg.2025.116572

Chi Li , Yu-Shan Juan , Hong-Liang Hu , Guan-Bo Tung

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引用次数: 0

Abstract

Background

This study examined the impact of frailty on in-hospital outcomes in patients undergoing surgical stabilization of multiple rib fractures and flail chest (SSRF).

Methods

This retrospective study used U.S. Nationwide Inpatient Sample data (2005–2020) to analyze patients ≥20 years old who underwent SSRF for multiple rib fractures. In-hospital outcomes (mortality, discharge status, complications) were compared between frail and non-frail groups using 1:4 propensity score matching (PSM).

Results

After PSM, 2690 patients were included in the analyses. Frail patients had a higher likelihood of being transferred to SNF or ICF (adjusted odds ratio [aOR] = 1.88; 95 % confidence interval [CI]: 1.46–2.43), higher total hospital costs (144.56 thousand USD; 95 % CI: 140.66–148.47), and increased risks of postoperative complications (aOR = 1.59; 95 % CI: 1.24–2.05), including tracheostomy, respiratory failure, and pneumonia.

Conclusions

Frailty increases the risk of adverse outcomes after SSRF, highlighting the importance of incorporating frailty assessment into perioperative care.

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虚弱对多处肋骨骨折和连枷胸术后肋骨骨折手术稳定后预后的影响：2005-2020年全国住院患者样本的倾向评分匹配分析

本研究探讨了虚弱对接受手术稳定多发性肋骨骨折和连枷胸（SSRF）患者住院结果的影响。方法本回顾性研究使用美国全国住院患者样本数据（2005-2020），分析≥20岁接受SSRF治疗多发性肋骨骨折的患者。采用1:4倾向评分匹配（PSM）比较体弱组和非体弱组的住院结果（死亡率、出院状况、并发症）。结果经PSM后，2690例患者纳入分析。体弱患者转入SNF或ICF的可能性较高（调整优势比[aOR] = 1.88； 95%可信区间[CI]: 1.46 ~ 2.43），住院总费用较高（144.56万美元；95% CI: 140.66 ~ 148.47），术后并发症风险较高（aOR = 1.59; 95% CI: 1.24 ~ 2.05），包括气管造口术、呼吸衰竭和肺炎。结论虚弱增加了SSRF术后不良结局的风险，强调了将虚弱评估纳入围手术期护理的重要性。

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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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.