The Impact of Delayed Intubation on Outcomes and Resource Utilization of Patients Sustaining Multiple Rib Fractures

Area of Science:

• Trauma Surgery
• Critical Care Medicine
• Respiratory Physiology

Background:

• Multiple rib fractures often necessitate mechanical ventilation due to respiratory insufficiency.
• The timing of intubation in these patients is a critical factor influencing outcomes.

Purpose of the Study:

• To investigate the association between delayed intubation and patient outcomes in adults with multiple rib fractures.
• To compare early versus delayed intubation strategies regarding mortality, complications, and resource utilization.

Main Methods:

• Analysis of the Trauma Quality Improvement Program database (2017-2021).
• Comparison of patients with early (<24 hours) versus delayed (≥24 hours) intubation after admission.
• Utilized inverse probability of treatment weighting and logistic regression for adjusted outcome analysis.

Main Results:

• Delayed intubation was associated with higher in-hospital mortality (19.7% vs 13.7%) and increased rates of ARDS, pulmonary embolism, severe sepsis, and acute kidney injury.
• Patients with delayed intubation experienced longer hospital and ICU stays, with increased mechanical ventilation duration.
• Delayed intubation independently increased the odds of mortality (OR 1.584).

Conclusions:

• Delayed intubation in patients with multiple rib fractures correlates with adverse clinical outcomes and elevated resource utilization.
• Early recognition of at-risk patients and consideration for early intubation are vital for improving survival and reducing complications.