title: The ribs or not the ribs: which influences mortality?
abstract: BACKGROUND
  The relative impact of rib fractures on mortality risk is unclear. This study examined the respective relationships between mortality and the number of fractured ribs, patient age, and severity of intrathoracic and extrathoracic injuries.
  
  
  METHODS
  The National Trauma Data Bank was queried, abstracting mortality, age, number of ribs fractured, associated intrathoracic and extrathoracic injury, and Abbreviated Injury Score codes.
  
  
  RESULTS
  Multivariate logistic regression indicated the strongest influence on mortality was severity of intrathoracic injury, followed by severity of extrathoracic injury, age 65 years or older, more than 5 ribs fractured, and age 46 to 65 years. The mortality rate for isolated rib fractures ranged from 1.8% to 3.2%.
  
  
  CONCLUSIONS
  Mortality related to rib fractures is affected independently by severe intrathoracic injury, presence of extrathoracic injury, advanced age, and more than 5 fractured ribs. Patients with these conditions may benefit from a higher level of care.
authors.affiliation: Division of General Surgery, Department of Surgery, Stritch School of Medicine, Loyola University Medical Center, 2160 South First Ave., Maywood, IL 60153, USA.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Jones
authors.forename: R Lawrence
authors.initials: RL
authors.lastname: Reed
authors.forename: Fred A
authors.initials: FA
authors.lastname: Luchette
mesh_terms: D015998:Abbreviated Injury Scale; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016208:Databases, Factual; D006801:Humans; D008875:Middle Aged; D009104:Multiple Trauma / Q000401:mortality; D015999:Multivariate Analysis; D012253:Rib Fractures / Q000401:mortality*; D013898:Thoracic Injuries / Q000401:mortality; D014481:United States / Q000453:epidemiology; D055815:Young Adult