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The ribs or not the ribs: which influences mortality?
Keith M Jones1, R Lawrence Reed, Fred A Luchette
1Division of General Surgery, Department of Surgery, Stritch School of Medicine, Loyola University Medical Center, 2160 South First Ave., Maywood, IL 60153, USA.
Background:
The relative impact of rib fractures on mortality risk is unclear. This study examined the respective relationships between mortality and the number of fractured ribs, patient age, and severity of intrathoracic and extrathoracic injuries.
Methods:
The National Trauma Data Bank was queried, abstracting mortality, age, number of ribs fractured, associated intrathoracic and extrathoracic injury, and Abbreviated Injury Score codes.
Results:
Multivariate logistic regression indicated the strongest influence on mortality was severity of intrathoracic injury, followed by severity of extrathoracic injury, age 65 years or older, more than 5 ribs fractured, and age 46 to 65 years. The mortality rate for isolated rib fractures ranged from 1.8% to 3.2%.
Conclusions:
Mortality related to rib fractures is affected independently by severe intrathoracic injury, presence of extrathoracic injury, advanced age, and more than 5 fractured ribs. Patients with these conditions may benefit from a higher level of care.
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