Predictors of Discharge Disposition Following Surgical Stabilization of Rib Fractures

Area of Science:

• Trauma Surgery
• Rehabilitation Medicine
• Health Services Research

Background:

• Patients undergoing surgical stabilization of rib fractures (SSRF) often require transitional care services.
• Discharge disposition influences recovery and resource utilization post-SSRF.
• Understanding factors predicting discharge setting is crucial for care planning.

Purpose of the Study:

• To identify demographic and surgical factors associated with discharge disposition following SSRF.
• To compare transitional care settings (home health care, skilled nursing facility, inpatient rehabilitation facility) versus routine discharge.

Main Methods:

• Retrospective analysis of approximately 10,000 patients undergoing SSRF (2017-2021) from the National Trauma Data Bank.
• Stratification by discharge status: routine, home health care (HHC), skilled nursing facility (SNF), or inpatient rehabilitation facility (IRF).
• Multinomial logistic regression models assessed associations between discharge disposition and patient/clinical factors.

Main Results:

• Older age, private insurance, and female sex were linked to higher odds of discharge to HHC, SNF, or IRF.
• Black patients showed lower odds of discharge to SNF and IRF compared to white patients.
• Higher injury severity, longer hospital stay, ventilator use, and pulmonary embolism increased odds of transitional care; fracture/plate counts did not significantly impact HHC/SNF discharge.

Conclusions:

• Patient characteristics and clinical factors significantly influence discharge disposition post-SSRF.
• These findings can inform transitional care planning, patient counseling, and potentially improve outcomes.
• Further research may optimize care pathways for SSRF patients.