“…20 Recently, Shulzhenko et al demonstrated that in older patients with trauma, sustaining at least five RF is a significant predictor of worse outcomes, independent of patients' characteristics, comorbidities, and trauma burden. 19 Our data regarding the need for tracheostomy in BCT patients with multiple RF are in accordance with the findings of the aforementioned studies, as our patients were severely injured and had on average > 5 fractured ribs. In addition, over 85% of our patients had pulmonary coinjuries, which according to recent publications are linked to the need for ventilatory support.…”