Impact of Chronic Obstructive Pulmonary Disease on Patients with Traumatic Rib Fractures

Al-Embideen, Somya; Jamil, Tahir; Stanek, Stephen M; Al-Jubouri, Mustafa A

doi:10.1097/01.xcs.0000933420.76917.f9

Cited by 1 publication

(1 citation statement)

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“…It has been shown to be associated with an increased length of stay, increased pneumonia rates, and a need for supplemental oxygen on discharge. 15 There are a few reasons to explain why patients with COPD have worse outcomes. Thoracic trauma can cause an acute COPD exacerbation.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Pulmonary Risk Factors and Combination Thoracic Osseous Fractures on Mortality and Outcomes of Surgical Stabilization of Rib Fractures

Tullington,

Brown,

Flippin

et al. 2024

The American Surgeon™

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Background Rib fixation for traumatic rib fractures is advocated to decrease morbidity and mortality in select patient populations. We intended to investigate the effect of combination osseous thoracic injuries on mortality with the hypothesis that combination injuries will worsen overall mortality and that SSRF will improve outcomes in combination injuries and in high-risk patients. Methods Patients with rib fractures were identified from the Trauma Quality Improvement Project registry from 2019. Patients were then divided into rib fracture(s) alone or in combination with sternal, thoracic vertebra, or scapula fracture. Patients were also categorized into those with COPD and smokers. Patients with AIS >3 outside of thorax were excluded. Patients were subcategorized into those who had rib fixation verse nonoperative management for all subgroups. Analysis was performed to evaluate the efficacy of rib fixation. Results A total of 111,066 patients were included for analysis. The overall mortality was 1.4%. Patients with COPD had over double the mortality risk, with an overall mortality of 3.4%. Combination injuries did not appear to increase mortality. SSRF did not decrease mortality; however, the number of patients in this group was too small to complete statistical analysis. The overall complication rate was 0.43%. There was a trend towards an increase in extrapulmonary complications in the group that underwent surgical fixation. Discussion Mortality from rib fractures with concomitant osseous thoracic fracture appears to be low. However, mortality is increased in patients with COPD regardless of rib fracture pattern. The number of patients who underwent SSRF was too small to make a statistical comparison.

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Section: Discussionmentioning

confidence: 99%