The Morbidity and Mortality of Rib Fractures

Ziegler, Daniel W.; Agarwal, Nikhileshwer N.

doi:10.1097/00005373-199412000-00018

Cited by 597 publications

(492 citation statements)

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“…1,2 In 2004, 764,000 patients presented to an emergency department in the USA for a thoracic injury. 1 The prevalence of rib fractures is from 4 to 10% amongst trauma patients requiring hospital admission, 2,3 with mortality and pulmonary complication rates ranging from 3 to 13% and from 16 to 60%, respectively.…”

Section: Résumémentioning

confidence: 99%

Effect of epidural analgesia in patients with traumatic rib fractures: a systematic review and meta-analysis of randomized controlled trials

Carrier

Turgeon

Nicole

et al. 2009

Can J Anesth/J Can Anesth

171

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Purpose A consensus group recently proposed epidural analgesia as the optimal analgesic modality for patients with multiple traumatic rib fractures. However, its beneficial effects are not consistently recognized in the literature. We performed a systematic review and a meta-analysis of randomized controlled trials (RCT) of epidural analgesia in adult patients with traumatic rib fractures. Methods A systematic search strategy was applied to MEDLINE, EMBASE, the Cochrane Library and to the annual meeting of relevant societies (up to July 2008). All randomized controlled trials comparing epidural analgesia with other analgesic modalities in adult patients with traumatic rib fractures were included. Primary outcomes were mortality, ICU length of stay (LOS), hospital LOS and duration of mechanical ventilation. Results Eight studies (232 patients) met eligibility criteria. Epidural analgesia did not significantly affect mortality (odds ratio [OR] 1.6, 95% CI, 0.3, 9.3, 3 studies, n = 89), ICU LOS (weighted mean difference [WMD] -3.7 days, 95% CI, -11.4, 4.0, 4 studies, n = 135), hospital LOS (WMD -6.7, 95% CI, -19.8, 6.4, 4 studies, n = 140) or duration of mechanical ventilation (WMD -7.5, 95% CI, -16.3, 1.2, 3 studies, n = 101). Duration of mechanical ventilation was decreased when only studies using thoracic epidural analgesia with local anesthetics were evaluated (WMD -4.2, 95% CI, -5.5, -2.9, 2 studies, n = 73). However, hypotension was significantly associated with the use of thoracic epidural analgesia with local anesthetics (OR 13.76, 95% CI, 2.89, 65.51, 3 studies, n = 99).Abstract presentation: Presented in part at the Residents' Competition at the 62nd Annual Meeting of the Canadian Anesthesiologists' Society,

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Section: Résumémentioning

confidence: 99%

Effect of epidural analgesia in patients with traumatic rib fractures: a systematic review and meta-analysis of randomized controlled trials

Carrier

Turgeon

Nicole

et al. 2009

Can J Anesth/J Can Anesth

171

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“…Because of the earthquake epicenter is close to the densely populated area the loss of life was greatly increased (1). In the English literature, chest traumas compose 10%-15% of all traumas and carry a mortality rate ranging from 8.2% to 33.3% (2,3). The leading cause of chest traumas is road traffic accidents, and the second through fourth most common causes are falls, assault, and work-related accidents, respectively (4,5).…”

Section: Introductionmentioning

confidence: 99%

Clinical Profile of Thorax and Lung Injuries Associated with the 2011 Van Earthquake in Turkey

et al. 2013

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The 7.2 and 5.6 magnitude earthquake that struck Turkey on October 23 and November 9, 2011, was Van, Turkey Received: 10.04.2012, Accepted: 11.10.2012 70agnosing the thoraks and lung injuries. Because of the limited capacity of the hospital and intensive care unit, some patients were transferred to reference hospitals during the hospitalization period. To avoid repetition in the census data, duplicate records were counted only in one hospital after matching the records. RESULTSThe mean age of the patients was 39.7 (2-83) years, and the mean time from rescue to first intervention was 14.5 (0.3-108) hours. Twenty one patients (53.8%) were female and 18 (46.2%) were male. Twenty percent (n:8) (5 females and 3 males) were over the age of 60. Of the 39 patients, bone fractures were detected in 29 (76.9%) patients. Pulmonary parenchymal injuries, pleural injuries, and soft-tissue changes were detected in 36 (92.3%), 31 (79.4%), and 29 (74.3%) patients, respectively. The distribution of the thorax injuries is summarized in Table 1. Pulmonary parenchymal injuries was the most frequent pathology Of the 39 patients, 36(92.3%) has had pulmonary injury. The distrubution was 19 (52.7%) had a hemopneumothorax, 8 (20.5%) had unilateral pneumothorax, 3 (7.6%) patients had hemothorax, one patient (2.5%) had a bilateral pneumothorax. 2 (5.1%) patients were followed up in the clinic that had sternal fractures. Twenty seven (69.2%) patients had rib fractures and among them eightteen had multiple rib fractures (Figure 4).

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“…En analyse multivariée, le seul facteur de risque de complications tardives statistiquement significatif é tait la localisation des fractures sur la radiographie de l'hé mithorax. Le rapport de cote ajusté se situe à 1,52 (IC 95% 0,62-3,73) pour les cô tes infé rieures (10-12e cô te), à 3,11 (IC 95% 1,60-6,08) pour les cô tes mé dianes (6-9e cô te), et à 5,05 (IC 95% 1,19) pour les cô tes supé rieures (troisiè me-cinquième cô te) par rapport aux patients sans fracture. Conclusion: La pré sence d'au moins une fracture de cô te entre la troisiè me et la neuvième cô te à la radiographie de l'hémithorax est un facteur de risque significatif d'hé mothorax et de pneumothorax tardifs.…”

Section: Ré Suméunclassified

“…1 Plus de 75% des patients avec fractures de cô tes ne requièrent pas d'hospitalisation et sont traités en ambulatoire. 2 Pourtant, ces derniers sont à risque de développer des complications pulmonaires tardives.…”

Section: Ré Suméunclassified

Étude de cohorte sur la prévalence et les facteurs de risque de complications pulmonaires tardives chez les adultes à la suite d'un traumatisme thoracique mineur fermé

Plourde

Émond²,

Lavoie³

et al. 2013

CJEM

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Objectifs: Les objectifs de cette é tude consistent à dé terminer la pré valence, les facteurs de risque, et le dé lai d'apparition de l'hé mothorax et du pneumothorax tardifs chez les adultes ayant subi un traumatisme thoracique mineur fermé . Mé thode: Une cohorte prospective de 450 patients consé cutifs a é té recruté e. Les patients é ligibles devaient ê tre â gé s de plus de 16 ans, avoir consulté en deç à de 72 heures pour un traumatisme et ê tre disponibles pour un suivi ambulatoire à 2, 7, et 14 jours suivant le traumatisme. Le ré sultat clinique recherché é tait la pré sence d'hé mothorax et de pneumothorax tardifs à la radiographie pulmonaire de contrô le. Ré sultats: L'hé mothorax tardif est survenu chez 11,8% (IC 95% 8,8-14,8%) et le pneumothorax tardif chez 0,9% (IC 95% 0,2-2,3%) des participants. Au cours de la pé riode de suivi de 14 jours, 87,0% de ces complications tardives se sont manifesté es durant la premiè re semaine. En analyse multivariée, le seul facteur de risque de complications tardives statistiquement significatif é tait la localisation des fractures sur la radiographie de l'hé mithorax. Le rapport de cote ajusté se situe à 1,52 (IC 95% 0,62-3,73) pour les cô tes infé rieures (10-12e cô te), à 3,11 (IC 95% 1,60-6,08) pour les cô tes mé dianes (6-9e cô te), et à 5,05 (IC 95% 1,19) pour les cô tes supé rieures (troisiè me-cinquième cô te) par rapport aux patients sans fracture. Conclusion: La pré sence d'au moins une fracture de cô te entre la troisiè me et la neuvième cô te à la radiographie de l'hémithorax est un facteur de risque significatif d'hé mothorax et de pneumothorax tardifs.

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The Morbidity and Mortality of Rib Fractures

Cited by 597 publications

References 0 publications

Effect of epidural analgesia in patients with traumatic rib fractures: a systematic review and meta-analysis of randomized controlled trials

Effect of epidural analgesia in patients with traumatic rib fractures: a systematic review and meta-analysis of randomized controlled trials

Clinical Profile of Thorax and Lung Injuries Associated with the 2011 Van Earthquake in Turkey

Étude de cohorte sur la prévalence et les facteurs de risque de complications pulmonaires tardives chez les adultes à la suite d'un traumatisme thoracique mineur fermé

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