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Time to surgical st...
Time to surgical stabilization of rib fractures : does it impact outcomes?
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- Forrester, Joseph D. (author)
- Stanford University, Stanford, California, USA
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- Sarani, Babak (author)
- Center of Trauma and Critical Care, The George Washington University, Washington, District of Columbia, USA
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- Forssten, Maximilian Peter, 1996- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedic Surgery, Örebro University Hospital, Örebro, Sweden
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- Cao, Yang, Associate Professor, 1972- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Clinical Epidemiology and Biostatistics
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- Hildebrand, Frank (author)
- Department of Orthopedics, Trauma, and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany
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- Mohammad Ismail, Ahmad, 1993- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Orthopedic Surgery
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- Ribeiro, Marcelo A. F. (author)
- Department of Surgery, Sheikh Shakhbout Medical City, Abu Dabi, Abu Dhabi, UAE
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- Mohseni, Shahin (author)
- Division of Trauma, Critical Care & Acute Care Surgery, Department of Surgery, Sheikh Shakhbout Medical City, Abu Dabi, UAE
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(creator_code:org_t)
- BMJ Publishing Group Ltd, 2024
- 2024
- English.
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In: Trauma surgery & acute care open. - : BMJ Publishing Group Ltd. - 2397-5776. ; 9:1
- Related links:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- OBJECTIVES: Rib fractures are common, morbid, and potentially lethal. Intuitively, if interventions to mitigate downstream effects of rib fractures can be implemented early, likelihood of developing these complications should be reduced. Surgical stabilization of rib fractures (SSRF) is one therapeutic intervention shown to be useful for mitigating complications of these common fractures. Our aim was to investigate for association between time to SSRF and complications among patients with isolated rib fractures undergoing SSRF.METHODS: The 2016-2019 American College of Surgeons Trauma Quality Improvement Program (TQIP) database was queried to identify patient >18 years with isolated thoracic injury undergoing SSRF. Patients were divided into three groups: SSRF ≤2 days, SSRF >2 days but <3 days, and SSRF >3 days. Poisson regression, and adjusting for demographic and clinical covariates, was used to evaluate the association between time to SSRF and the primary endpoint, in-hospital complications. Quantile regression was used to evaluate the effects of time to SSRF on the secondary endpoints, hospital and intensive care unit (ICU) length of stay (LOS).RESULTS: Out of 2185 patients, 918 (42%) underwent SSRF <2 days, 432 (20%) underwent SSRF >2 days but <3 days, and 835 (38%) underwent SSRF >3 days. Hemothorax was more common among patients undergoing SSRF >3 days, otherwise all demographic and clinical variables were similar between groups. After adjusting for potential confounding, SSRF >3 days was associated with a threefold risk of composite in-hospital complications (adjusted incidence rate ratio: 3.15, 95% CI 1.76 to 5.62; p<0.001), a 4-day increase in total hospital LOS (change in median LOS: 4.09; 95% CI 3.69 to 4.49, p<0.001), and a nearly 2-day increase in median ICU LOS (change in median LOS: 1.70; 95% CI 1.32 to 2.08, p<0.001), compared with SSRF ≤2 days.CONCLUSION: Among patients undergoing SSRF in TQIP, earlier SSRF is associated with less in-hospital complications and shorter hospital stays. Standardization of time to SSRF as a trauma quality metric should be considered.LEVEL OF EVIDENCE: Level II, retrospective.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Outcome Assessment
- Health Care
- Thoracic Surgical Procedures
- Time-To-Treatment
- rib fractures
Publication and Content Type
- ref (subject category)
- art (subject category)
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