Elderly trauma patients with rib fractures are at greater risk of death and pneumonia.
BACKGROUND
The purpose of this study was to show that elderly patients admitted with rib fractures after blunt trauma have increased mortality.


METHODS
Demographic, injury severity, and outcome data on a cohort of consecutive adult trauma admissions with rib fractures to a tertiary care trauma center from April 1, 1993, to March 31, 2000, were extracted from our trauma registry.


RESULTS
Among 4,325 blunt trauma admissions, there were 405 (9.4%) patients with rib fractures; 113 were aged > or = 65. Injuries were severe, with Injury Severity Score (ISS) > or = 16 in 54.8% of cases, a mean hospital stay of 26.8 +/- 43.7 days, and 28.6% of patients requiring mechanical ventilation. Mortality (19.5% vs. 9.3%; p < 0.05), presence of comorbidity (61.1% vs. 8.6%; p < 0.0001), and falls (14.6% vs. 0.7%; p < 0.0001) were significantly higher in patients aged > or = 65 despite significantly lower ISS (p = 0.031), higher Glasgow Coma Scale score (p = 0.0003), and higher Revised Trauma Score (p < 0.0001). After adjusting for severity (i.e., ISS and Revised Trauma Score), comorbidity, and multiple rib fractures, patients aged > or = 65 had five times the odds of dying when compared with those < 65 years old.


CONCLUSIONS
Despite lower indices of injury severity, even after taking account of comorbidities, mortality was significantly increased in elderly patients admitted to a trauma center with rib fractures.
Bergeron
Eric
E
Choc-trauma Montérégie, Hôpital Charles-LeMoyne, Greenfield Park, Quebec, Canada. eric.bergeron@traumaquebec.ca
Lavoie
Andre
A
Clas
David
D
Moore
Lynne
L
Ratte
Sebastien
S
Tetreault
Stephane
S
Lemaire
Jacques
J
Martin
Marcel
M
D000368:Aged; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D050723:Fractures, Bone / Q000145:classification / Q000150:complications* / Q000401:mortality; D005853:Geriatrics; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology*; D012272:Ribs / Q000293:injuries*; D012307:Risk Factors