Evaluation of surgical outcomes in elderly patients with rib fractures: a single-centre propensity score matching study

Abstract

Rib fractures are the most common injuries in chest trauma. Compared with younger patients, elderly patients with rib fracture have a higher incidence of complications and mortality. We performed a retrospective analysis of 703 elderly patients with rib fractures treated in the Thoracic Surgery Department of Beijing Jishuitan Hospital between 2013 and 2020. We investigated the effect of surgical stabilization of rib fracture (SSRF) on the outcome of rib fracture using a 1:1 propensity score matching method. The study included 121 surgical patients who received SSRF and 121 control patients who received conservative treatment. The length of hospital stay in the surgery group was significantly longer than that in the conservative group (P = 0.000), while the length of ICU stay (P = 0.222), length of mechanical ventilation (P = 0.231), and the mortality rate (P = 0.175) were not significantly different between the two groups. After 9 months of follow-up, the fracture healing rate in the surgery group was significantly higher than that in the control group (P = 0.020). The fracture healing time (P = 0.000), improvement in pain score (P = 0.000) and duration of pain medication use (P = 0.000) were also significantly better in the surgery group than in the control group. Compared with conservative treatment, surgical treatment can prolong hospital stay to some extent. However, it has the advantages of more rapid healing and lessened pain. For rib fractures in elderly individuals, surgical treatment does not significantly increase mortality when applied under strict surgical indications and is recommended.