Evolving Outcomes After Rib Fractures in Geriatric Patients: Revisiting Historical Data in the Modern Era

Area of Science:

• Geriatric Trauma
• Thoracic Surgery
• Critical Care Medicine

Background:

• Rib fractures in the elderly are linked to severe illness and mortality.
• Previous data on rib fracture outcomes is outdated, relying on 1980s-1990s X-ray imaging.
• Computed tomography (CT) is now standard, and management strategies have advanced.

Purpose of the Study:

• To evaluate the impact of each additional rib fracture on geriatric outcomes.
• To determine if mortality rates have decreased compared to historical data.
• To assess the association between rib fractures and complications like pneumonia and death in the elderly.

Main Methods:

• Retrospective review of a trauma registry over 5 years.
• Inclusion of geriatric patients (≥65 years) admitted with rib fractures.
• Analysis of rib fracture data from initial CT scans and patient outcomes using regression models.

Main Results:

• 709 patients had an average of 4.2 rib fractures.
• Deep vein thrombosis, cerebrovascular accident, and respiratory failure were linked to more fractures.
• Mortality was 7.0% for ≤6 fractures but rose to 20.6% for >6 fractures, with increased risk per fracture in the latter group.
• Increasing age, bilateral fractures, and pulmonary contusions also significantly increased mortality.

Conclusions:

• Outcomes for elderly patients with rib fractures have improved but remain a challenge.
• Each additional rib fracture increases the odds of respiratory failure by 16.1%.
• Mortality risk increases with age, number of fractures (especially >6), bilateral fractures, and pulmonary contusions.