title: The severity of liver injury following blunt trauma does not correlate with the number of fractured ribs: an analysis of a national trauma registry database.
abstract: OBJECTIVE
  Rib fractures are a marker of severe injury, predicting a higher incidence of associated injuries. The purpose of this study was to assess whether an increasing number of rib fractures predicts the severity of liver injury in blunt trauma patients.
  
  
  METHODS
  We performed a retrospective cohort study involving blunt trauma patients with concomitant liver injuries and rib fractures who were registered in a national trauma registry.
  
  
  RESULTS
  Of 57,130 patients with blunt torso injuries, 14,651 patients sustained rib fractures, and 2,899 patients suffered liver injuries. Concomitant liver injury occurred in 1,087 of the patients with rib fractures (7.4%), while 1,812 patients sustained liver injury without rib fractures (4.3%). The presence of six or more rib fractures predicted a higher incidence of liver injury. Among the patients with liver injury, those with concomitant rib fractures had a higher Injury Severity Score (ISS), but similar mortality rates. Among the patients with concomitant rib fractures and liver injury, there was no relationship between the number of fractured ribs and the severity of the liver injury.
  
  
  CONCLUSIONS
  Although the presence of rib fractures was associated with an increased probability of liver injury in patients with blunt torso trauma, there is no relationship between the number of fractured ribs and the severity of liver injury.
authors.affiliation: General Surgery Department, Bnai-Zion Medical Center, Rappoport Medical School, Technion, Haifa Golomb 47, Haifa, 31048, Israel, foratola@gmail.com.
authors.forename: Forat
authors.initials: F
authors.lastname: Swaid
authors.forename: Kobi
authors.initials: K
authors.lastname: Peleg
authors.forename: Ricardo
authors.initials: R
authors.lastname: Alfici
authors.forename: Oded
authors.initials: O
authors.lastname: Olsha
authors.forename: Igor
authors.initials: I
authors.lastname: Jeroukhimov
authors.forename: Adi
authors.initials: A
authors.lastname: Givon
authors.forename: Boris
authors.initials: B
authors.lastname: Kessel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D007557:Israel / Q000453:epidemiology; D008099:Liver / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D012042:Registries; D012189:Retrospective Studies; D012253:Rib Fractures / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult