PMID- 34268852
OWN - NLM
STAT- MEDLINE
DCOM- 20210916
LR  - 20210916
IS  - 1445-2197 (Electronic)
IS  - 1445-1433 (Linking)
VI  - 91
IP  - 9
DP  - 2021 Sep
TI  - Outcomes of rib fractures in the geriatric population: A 5-year retrospective, 
      single-institution, Australian study.
PG  - 1886-1892
LID - 10.1111/ans.17064 [doi]
AB  - BACKGROUND: Surgical rib fixation in the general population can decrease 
      morbidity, including length of stay and ventilator days. Elderly rib fractures 
      convey high rates of morbidity and mortality, and it is unclear whether this 
      population benefits from operative management. METHODS: A single-centre, 
      retrospective study at a Level 1 Australasian trauma centre was conducted. 
      Registry-identified patients aged >/=70 years, admitted to hospital with blunt 
      trauma-induced rib fractures, were included. Outcome measures included 
      demographics, pre-morbid function, acute length of stay, intensive care unit 
      admission, injury characteristics, management and complications. RESULTS: A total 
      of 920 presentations were identified, with 295 meeting the inclusion criteria. 
      Falls accounted for majority (n = 148/295, 50.2%), with a median Injury Severity 
      Score of 10 (inter-quartile range [IQR] 10-14). Severe chest trauma occurred 
      overall in 80% (n = 243/294) and all operative patients (n = 15/15). Conservative 
      management was used in 95% (n = 280/295). Patient-controlled analgesia was common 
      (n = 177/295, 60.0%) and regional techniques increased in the surgical approach 
      (n = 12/15, 80.0%) compared with conservative approach (n = 71/280, 25.4%). 
      Despite longer acute length of stay (12 days, IQR 9-15), operative management 
      resulted in similar complications (26.7% vs. 30.4%) and no deaths. Operative 
      intervention was significantly associated with increased number of fractures 
      (p < 0.001), flail segment (p = 0.001) and higher chest Abbreviated Injury Score 
      (p < 0.001); however, it was not significantly associated with age (p = 0.90), 
      comorbidities (0.91) or anticoagulation (p = 0.51). CONCLUSION: Surgical 
      management of rib fractures in the elderly was performed without increased 
      complications within this centre's multimodal approach. Standard indications for 
      rib fixation may be applicable in the elderly population, whilst comorbidities, 
      age and anticoagulation use alone may not be adequate reasons to withhold 
      surgical rib fixation.
CI  - (c) 2021 Royal Australasian College of Surgeons.
FAU - Cooper, Emma
AU  - Cooper E
AUID- ORCID: 0000-0001-5782-7699
AD  - Intensive Care Unit, Gold Coast Hospital and Health Service, Southport, 
      Queensland, Australia.
AD  - Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, 
      Australia.
FAU - Wake, Elizabeth
AU  - Wake E
AUID- ORCID: 0000-0002-1690-3154
AD  - Trauma Service, Gold Coast University Hospital, Southport, Queensland, Australia.
AD  - School of Medicine, Griffith University, Southport, Queensland, Australia.
FAU - Cho, Charlie
AU  - Cho C
AD  - Trauma Service, Gold Coast University Hospital, Southport, Queensland, Australia.
FAU - Wullschleger, Martin
AU  - Wullschleger M
AD  - Trauma Service, Gold Coast University Hospital, Southport, Queensland, Australia.
AD  - School of Medicine, Griffith University, Southport, Queensland, Australia.
FAU - Patel, Bhavik
AU  - Patel B
AUID- ORCID: 0000-0002-6179-0507
AD  - Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, 
      Australia.
AD  - Trauma Service, Gold Coast University Hospital, Southport, Queensland, Australia.
LA  - eng
PT  - Journal Article
DEP - 20210716
PL  - Australia
TA  - ANZ J Surg
JT  - ANZ journal of surgery
JID - 101086634
SB  - IM
MH  - Aged
MH  - Australia/epidemiology
MH  - *Flail Chest
MH  - Fracture Fixation, Internal
MH  - Humans
MH  - Length of Stay
MH  - Retrospective Studies
MH  - *Rib Fractures/epidemiology/surgery
OTO - NOTNLM
OT  - aged
OT  - fracture fixation
OT  - geriatrics
OT  - internal
OT  - rib fractures
OT  - thoracic injuries
EDAT- 2021/07/17 06:00
MHDA- 2021/09/18 06:00
CRDT- 2021/07/16 06:58
PHST- 2021/06/27 00:00 [revised]
PHST- 2020/10/31 00:00 [received]
PHST- 2021/06/29 00:00 [accepted]
PHST- 2021/07/17 06:00 [pubmed]
PHST- 2021/09/18 06:00 [medline]
PHST- 2021/07/16 06:58 [entrez]
AID - 10.1111/ans.17064 [doi]
PST - ppublish
SO  - ANZ J Surg. 2021 Sep;91(9):1886-1892. doi: 10.1111/ans.17064. Epub 2021 Jul 16.