Feng LR, Lilienthal M, Galet C, Skeete DA. Frailty as a predictor of negative outcomes in trauma patients with rib fractures.
Surgery 2023;
173:812-820. [PMID:
36257861 DOI:
10.1016/j.surg.2022.07.046]
[Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/01/2022] [Accepted: 07/30/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND
In patients with rib fractures, adverse outcomes are associated with number of rib fractures; however, studies suggest an association with frailty. We assessed whether frailty, measured using the Canadian Study of Health and Aging clinical frailty scale, was associated with adverse outcomes in this population.
METHODS
Patients ≥50 years admitted for rib fractures from July 2015 to June 2020 were retrospectively scored for frailty. Demographics, comorbidities, injury information, hospital course, and complications were collected. Univariate analyses were performed to assess significant differences between the fit, prefrail, and frail groups. The association between number of rib fractures and frailty with outcomes was determined.
RESULTS
Controlling for age, sex, Injury Severity Score, preadmission anticoagulant, injury mechanism, and comorbidities and nonchest Abbreviated Injury Scores showing significant differences, the number of rib fractures was associated with developing pneumonia (odds ratio = 1.197 [1.076-1.332]; P = .001), hospital length of stay (odds ratio = 1.066 [1.033-1.100], P < .001), mortality (odds ratio = 1.157 [1.048-1.278], P = .004), and discharge to long-term acute care facilities (odds ratio = 1.295 [1.084-1.546], P = .004). Frailty was associated with hospital length of stay (odds ratio = 1.659 [1.059-2.598], P = .027) and discharge to skilled nursing facilities (odds ratio = 5.282 [1.567-17.802], P = .007).
CONCLUSION
In our population, the number of rib fractures was associated with respiratory complications and mortality. Frailty was associated with longer hospitalization and discharge to higher level of care.
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