Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands

Peek, Jesse; Beks, Reinier B.; Hietbrink, Falco; Jong, Mirjam B. de; Heng, Marilyn; Beeres, Frank J. P.; IJpma, Frank F. A.; Leenen, Loek P. H.; Groenwold, Rolf H H; Houwert, Roderick M.

doi:10.1007/s00068-020-01412-2

Cited by 41 publications

(38 citation statements)

References 19 publications

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“…The incidence rate increased sharply with age, from 34 to 107 per 100,000 person years in patients aged ≤ 65 years and ≥ 65 years, respectively. The incidence rate of 72 per 100,000 person years for admitted elderly patients is again in line with previous literature [18,20]. Furthermore, the increase of 37% of the total number of patients with rib fractures between 2015 and 2018 demonstrates that rib fractures are a common and increasing problem, especially among the elderly [33].…”

Section: Discussionsupporting

confidence: 89%

“…The incidence rate of 29 per 100,000 person years for admitted patients is similar to the incidence rate demonstrated by a recent study focusing only on admitted patients [18]. The incidence rate for the total cohort of 47 per 100,000 person years showed that rib fractures are common and not all patients require admission.…”

Section: Discussionsupporting

confidence: 85%

“…At 2 years post-injury, almost onethird of patients has not yet returned to their pre-injury work level [17]. While the prevalence of rib fractures is known, the incidence rate of rib fractures has only been studied in hospitalized patients or the elderly [18][19][20]. Although the disabling effect of rib fractures on short-and long-term outcomes is indisputable, the economic effect on health care use, work absence, and associated detailed evaluations of direct and indirect costs has hardly been studied.…”

Section: Introductionmentioning

confidence: 99%

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Trends in incidence rate, health care use, and costs due to rib fractures in the Netherlands

Prins

Wijffels

Wooldrik

et al. 2021

Eur J Trauma Emerg Surg

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Purpose This study aimed to examine population-based trends in the incidence rate, health care consumption, and work absence with associated costs in patients with rib fractures. Methods A retrospective nationwide epidemiologic study was performed with data from patients with one or more rib fractures presented or admitted to a hospital in the Netherlands between January 1, 2015 and December 31, 2018 and have been registered in the Dutch Injury Surveillance System (DISS) or the Hospital Discharge Registry (HDR). Incidence rates were calculated using data from Statistics Netherlands. The associated direct health care costs, costs for lost productivity, and years lived with disability (YLD) were calculated using data from a questionnaire. Results In the 4-year study period, a total of 32,124 patients were registered of which 19,885 (61.9%) required hospitalization with a mean duration of 7.7 days. The incidence rate for the total cohort was 47.1 per 100,000 person years and increased with age. The mean associated direct health care costs were €6785 per patient and showed a sharp increase after the age of 75 years. The mean duration of work absence was 44.2 days with associated mean indirect costs for lost productivity of €22,886 per patient. The mean YLD was 0.35 years and decreased with age. Conclusion Rib fractures are common and associated with lengthy HLOS and work absenteeism as well as high direct and indirect costs which appear to be similar between patients with one or multiple rib fractures and mostly affected by admitted patients and age.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Trends in incidence rate, health care use, and costs due to rib fractures in the Netherlands

Prins

Wijffels

Wooldrik

et al. 2021

Eur J Trauma Emerg Surg

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“…The aim of the DTR is to uphold and monitor good standard of care for injured patients. The DTR has been used for nationwide retrospective cohort studies before, such as Peek et al 15 . The DTR contains data of all trauma patients who were admitted to hospital through A&E, within 48 h of trauma.…”

Section: Methodsmentioning

confidence: 99%

Incidence, causes and consequences of moderate and severe traumatic brain injury as determined by Abbreviated Injury Score in the Netherlands

Jochems

Rein

Niemeijer

et al. 2021

Sci Rep

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Traumatic brain injury (TBI) is a leading cause of death and disability. Epidemiology seems to be changing. TBIs are increasingly caused by falls amongst elderly, whilst we see less polytrauma due to road traffic accidents (RTA). Data on epidemiology is essential to target prevention strategies. A nationwide retrospective cohort study was conducted. The Dutch National Trauma Database was used to identify all patients over 17 years old who were admitted to a hospital with moderate and severe TBI (AIS ≥ 3) in the Netherlands from January 2015 until December 2017. Subgroup analyses were done for the elderly and polytrauma patients. 12,295 patients were included in this study. The incidence of moderate and severe TBI was 30/100.000 person-years, 13% of whom died. Median age was 65 years and falls were the most common trauma mechanism, followed by RTAs. Amongst elderly, RTAs consisted mostly of bicycle accidents. Mortality rates were higher for elderly (18%) and polytrauma patients (24%). In this national database more elderly patients who most often sustained the injury due to a fall or an RTA were seen. Bicycle accidents were very frequent, suggesting prevention could be an important aspect in order to decrease morbidity and mortality.

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“…This was probably underestimated herein as those suffering minor thoracic injuries (AIS Thorax =1), including single rib fractures, were excluded. Peek et al recently reported in their nationwide studies that single rib fracture were frequently encountered injuries (20% of rib fractures) [24,25]. We chose not to include these patients because previous studies have demonstrated that these single rib fractures were not associated with mortality [9].…”

Section: Discussionmentioning

confidence: 99%

Impact of Thoracic Trauma on the Mortality of Multi-trauma Patients: It Matters - Results From a French Road Trauma Registry 1997-2016

Benhamed

Ndiaye

Lieutaud

et al. 2021

Preprint

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BackgroundThoracic trauma is the third most common cause of death in multi-trauma patients and is associated with poor short-term outcomes since it is responsible for up to 25% of trauma-related deaths. One of the most frequent mechanism is road traffic accident (RTA), affecting particularly young patients. The primary objective of the present study was to investigate the influence of severe injuries in each body region on the mortality of multi-trauma patients with a particular attention to thoracic trauma. Secondary objectives were to investigate risk factors for mortality in multi-trauma patients but also to describe the epidemiology and injury pattern of these patients when presenting with at least one abbreviated injury scale (AIS) ≥2 thoracic injury (AISThorax≥2).MethodsRetrospective study that included RTA occurring from January 1997 to December 2016. Patients of all ages included in the Rhône RTA registry, with at least one AIS ≥2 injury in any body region were included. Two subgroups were defined according to whether patients presented at least one AISThorax≥2 injury or not. Multivariate regression analysis with mortality as outcome was performed. ResultsA total of 46,526 patients had at least one AIS≥2 injury, among them 6,382 (13.7%) had at least one AISThorax≥2 injury. In the AISThorax≥2 group, the median [IQR] ISS was 14 [6-7] and 16.2% (n=1,031) patients died. Severe (AIS≥3) head (OR=26.8, 95%CI [20.4;35.2]) and thoracic (OR=12.2, 95%CI [8.4;17.7]) injuries were associated with death; as was age [40-59 years (OR=1.3, 95%CI [1.1;1.5]), 60-79 years (OR=2.1, 95%CI [1.7;2.6]), and ≥80 years (OR=5.5, 95%CI [4.2;7.3])], male sex (OR=1.5, 95%CI [1.3;1.7]), RTA occurring in a highway (OR=1.9, 95%CI [1.5;2.4]) or in a rural road (OR=1.8, 95%CI [1.5;2.1]). The most frequent thoracic injury was that of the chest wall (62.1%, n=5,419). The most frequent concomitant AIS≥2 injuries affected the head (29.1%), upper extremities (26.8%), and lower extremities (25.8%).ConclusionsThe present study found that the severity of thoracic trauma was an independent and significant risk factor for death in multi-trauma patients as was age, being a car occupant and having a crash in a rural road or a highway.

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Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands

Cited by 41 publications

References 19 publications

Trends in incidence rate, health care use, and costs due to rib fractures in the Netherlands

Trends in incidence rate, health care use, and costs due to rib fractures in the Netherlands

Incidence, causes and consequences of moderate and severe traumatic brain injury as determined by Abbreviated Injury Score in the Netherlands

Impact of Thoracic Trauma on the Mortality of Multi-trauma Patients: It Matters - Results From a French Road Trauma Registry 1997-2016

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