Assessing the true risk of abdominal solid organ injury in hospitalized rib fracture patients.
BACKGROUND
Despite the lack of evidence, traditional trauma teaching has suggested that low rib fractures increase the risk of abdominal solid organ injury (ASOI). This study was designed to assess if in fact this is true, and to try and define other factors that increased the risk of ASOI in rib fracture patients.


METHODS
The charts of 476 hospitalized rib fracture trauma patients were reviewed. Data were collected for age; sex; Injury Severity Score (ISS); rib fracture location; and the presence or absence of injuries to the abdominal organs, head, neck, face, thorax, great vessel, heart, thoracolumbar spine, pelvis, and extremities.


RESULTS
The probability of liver injury increased with the presence of any right-sided rib fracture, any low rib fracture, female gender, young age, and an elevated ISS. The probability of splenic injury increased with the presence of left-sided rib fractures only, any low rib fracture, young age, and an elevated ISS.


CONCLUSIONS
In hospitalized trauma patients, low rib fractures, right-sided rib fractures, female gender, young age, and an elevated ISS increased the probability of liver injury; and low rib fractures, left-sided only rib fractures, young age, and an elevated ISS increased the probability of splenic injury. Associated pelvic fractures and long bone fractures did not increase the likelihood of ASOI in this cohort.
Shweiki
E
E
Department of General Surgery/Trauma, Geisinger Medical Center, Danville, Pennsylvania, USA. eshweiki@yahoo.com
Klena
J
J
Wood
G C
GC
Indeck
M
M
D000007:Abdominal Injuries / Q000145:classification / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000145:classification / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D016017:Odds Ratio; D010414:Pennsylvania / Q000453:epidemiology; D011237:Predictive Value of Tests; D011336:Probability; D012189:Retrospective Studies; D012253:Rib Fractures / Q000145:classification / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D012307:Risk Factors; D017678:Sex Distribution; D013154:Spleen / Q000293:injuries; D014781:Viscera / Q000293:injuries*