Rib Season: Temporal Variation in Chest Wall Injuries

Area of Science:

• Trauma surgery
• Injury epidemiology
• Public health

Background:

• Chest wall injuries (CWIs) are common, but their seasonal incidence patterns are not well-understood.
• Understanding temporal variations in CWI frequency can aid resource allocation and prevention efforts.
• No prior studies have systematically evaluated seasonal trends in chest wall trauma.

Purpose of the Study:

• To determine if chest wall injuries (CWIs) exhibit consistent, reproducible annual seasonal variations.
• To identify peak and low incidence periods for moderate-to-severe CWIs and predominant CWIs (pCWIs).
• To explore potential correlations between injury mechanisms and seasonal patterns.

Main Methods:

• A 4-year retrospective review of a traumatic blunt CWI database from an urban level 1 trauma center.
• Inclusion criteria: moderate-to-severe chest wall injury (Abbreviated Injury Score [AIS] ≥2).
• Analysis included descriptive statistics, Poisson time-series regression for periodicity, and seasonal comparisons using t-tests and ANOVA (P < 0.05).

Main Results:

• Over 3000 blunt CWIs were identified between 2014-2017.
• August showed the highest incidence for all CWI categories; February had the lowest overall and moderate-to-severe incidence.
• A significant seasonal pattern emerged, with a high-incidence season from June-October and a low season from December-April. Motorcycle collisions increased during summer months.

Conclusions:

• Significant seasonal variation exists for overall CWIs and severe pCWIs, with summer months being the high-volume period.
• Winter months (December-April) represent the low-volume season for chest wall injuries.
• Findings suggest that seasonal patterns, particularly increased motorcycle accidents in summer, can inform targeted injury prevention and resource management.