title: Elderly trauma patients with rib fractures are at greater risk of death and pneumonia.
abstract: 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.
authors.affiliation: Choc-trauma Montérégie, Hôpital Charles-LeMoyne, Greenfield Park, Quebec, Canada. eric.bergeron@traumaquebec.ca
authors.forename: Eric
authors.initials: E
authors.lastname: Bergeron
authors.forename: Andre
authors.initials: A
authors.lastname: Lavoie
authors.forename: David
authors.initials: D
authors.lastname: Clas
authors.forename: Lynne
authors.initials: L
authors.lastname: Moore
authors.forename: Sebastien
authors.initials: S
authors.lastname: Ratte
authors.forename: Stephane
authors.initials: S
authors.lastname: Tetreault
authors.forename: Jacques
authors.initials: J
authors.lastname: Lemaire
authors.forename: Marcel
authors.initials: M
authors.lastname: Martin
mesh_terms: 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