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Rib fractures: relationship with pneumonia and mortality
Karen J Brasel1, Clare E Guse, Peter Layde
1Department of Surgery, Injury Research Center, Medical College of Wisconsin, USA.
Critical Care Medicine
|April 21, 2006
Summary
Age and Injury Severity Score are key predictors of mortality in patients with rib fractures. Pneumonia increases mortality risk only in isolated thoracic trauma cases, not in multiple-system injuries.
Area of Science:
- Trauma surgery
- Critical care medicine
- Epidemiology
Background:
- Age is a known risk factor for mortality following rib fractures.
- Previous studies were limited by small sample sizes, hindering comprehensive risk factor analysis.
Purpose of the Study:
- To identify independent risk factors for pneumonia and mortality in patients with rib fractures using a large national database.
- To analyze the impact of age, Injury Severity Score, and comorbidities on outcomes.
Main Methods:
- Database analysis of the 1999 Nationwide Inpatient Sample.
- Inclusion of patients with rib fractures, abstracting data on age, gender, fracture severity, comorbidities, pneumonia, and mortality.
- Multivariate analysis to determine independent predictors of pneumonia and mortality.
Main Results:
- Analysis included 17,308 patients with rib fractures; mean age was 56, mean Injury Severity Score was 13.1.
- Mortality rate was 4%, and pneumonia occurred in 6% of patients.
- Age and Injury Severity Score were significant predictors of both mortality and pneumonia. Comorbidity score and pneumonia were associated with mortality only in isolated thoracic trauma.
Conclusions:
- Age and Injury Severity Score are the primary predictors of mortality in patients with rib fractures and multiple-system injury.
- Pneumonia is a significant mortality predictor solely in cases of isolated thoracic trauma.
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