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Rib fractures in the elderly population: a systematic review
Ruben J Hoepelman1,2, Frank J P Beeres2,3, Marilyn Heng4
1Department of Trauma Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.
Archives of Orthopaedic and Trauma Surgery
|February 9, 2022
Summary
Surgical fixation may reduce mortality for elderly patients with multiple rib fractures, but evidence quality is low. More research is needed to confirm benefits for elderly patients with multiple rib fractures.
Area of Science:
- Trauma Surgery
- Geriatric Medicine
- Critical Care Medicine
Background:
- Multiple rib fractures pose significant risks in elderly patients.
- Surgical stabilization is increasingly considered for this demographic.
- This review compares conservative versus surgical treatment for elderly patients (over 60) with multiple rib fractures.
Approach:
- A systematic review of comparative studies was conducted.
- Searched multiple databases for relevant observational studies and randomized clinical trials.
- Included studies focused on elderly patients (over 60) with multiple rib fractures.
Key Points:
- Mortality was lower with surgical fixation (4%) versus conservative treatment (8%).
- Pneumonia rates and duration of mechanical ventilation were similar between groups.
- Operative patients had longer hospital (12.7 days) and ICU (6.5 days) stays, with more severe injuries (8.4 fractures, 47% flail chest).
Conclusions:
- The individual impact of conservative and operative treatments on morbidity and mortality in elderly patients with multiple rib fractures remains unclear.
- Current evidence quality is low.
- High-quality comparative observational studies or randomized controlled trials are necessary to determine the efficacy of operative treatment.
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