Predictors of Discharge Disposition Following Surgical Stabilization of Rib Fractures

Introduction: Patients are commonly discharged to either home health care (HHC), skilled nursing facility (SNF), or inpatient rehabilitation facility (IRF) following surgical stabilization of rib fractures (SSRF) to assist with recovery. This study explores demographic and surgical factors that may be associated with discharge disposition to a transitional care setting (HHC, SNF, and IRF) relative to routine discharge (self-care) following SSRF. Methods: Patients who underwent SSRF between 2017 and 2021 were included using retrospective data from the National Trauma Data Bank. Patients were stratified by discharge status: routine, HHC, SNF, or IRF. Multinomial logistic regression models were estimated to assess the association between discharge disposition and patient demographic and clinical factors. Results: We abstracted approximately 10, 000 SSRF patients between 2017 and 20. Older age, private insurance, and female sex were associated with greater odds of discharge to either HHC, SNF, or IRF than routine discharge. Compared to white patients, black patients were associated with lower odds of discharge to SNF and IRF. Injury severity score, hospital length of stay, time on ventilator, and experiencing a pulmonary embolism were associated with greater odds of discharge to HHC, SNF, and IRF relative to routine. However, the number of ribs fractures and plated were not significantly associated with discharge to HHC or SNF (P > 0.05). Conclusion: This study indicates several patient characteristics and surgical factors to consider when forming a transitional care plan for patients following SSRF, which may help guide patient counseling and improve postoperative outcomes.