Age-Neutral Surgical Stabilization of Rib Fractures: Breaking the Ageism Barrier

Area of Science:

• Trauma Surgery
• Surgical Outcomes Research
• Health Disparities

Background:

• Surgical stabilization of rib fractures (SSRF) is linked to reduced mortality and fewer complications.
• Existing research suggests SSRF benefits patients, but its utilization across different demographics requires further investigation.

Purpose of the Study:

• To determine if age, race, ethnicity, or insurance status influences the decision to perform SSRF.
• To assess the impact of these demographic factors on clinical outcomes following SSRF.

Main Methods:

• Retrospective analysis of patients aged 45 and older who underwent SSRF between 2016-2020 using the Trauma Quality Improvement Program database.
• Data collected included patient demographics (age, race, ethnicity, insurance status) and clinical outcomes (ventilator-associated pneumonia, reintubation, ARDS, mortality, failure to rescue).
• Logistic regression models controlled for covariates such as BMI, Injury Severity Score, and comorbidities.

Main Results:

• No significant differences in clinical outcomes were observed between age groups (45-64 and 65+).
• Black and Hispanic patients, as well as those with Medicaid insurance, were significantly less likely to receive SSRF.
• Age did not affect the association between SSRF and adverse outcomes like pneumonia, ARDS, or mortality.

Conclusions:

• Older adults (65+) experience similar clinical outcomes to younger adults (45-64) after SSRF and should not be excluded from this procedure.
• Significant underutilization of SSRF in Black, Hispanic, and Medicaid patients highlights critical health disparities.
• Further research and interventions are necessary to address and rectify the disparities in SSRF access for underrepresented groups.