Correlation Between Rib Fractures and Prognosis in Multiple Trauma Patients




Background: Thoracic trauma is an important cause of morbidity and mortality in trauma patients and rib fracture due to blunt trauma to the chest wall is the most common etiology. Objectives: This study analyzed the correlation between rib fractures and prognosis in multiple trauma patients. Methods: One hundred eighty-four trauma patients suffering from rib fracture due to the blunt trauma were studied. Demographic data, injury characteristics, rib fracture characteristics, the associated injuries, and injury severity score (ISS) were recorded. The rib fracture was classified according to location (left, right, and bilateral) and level (upper [1st - 2nd rib], middle [3rd - 8th rib], and lower [9th - 12th rib]); it also was categorized as lateral and posterolateral. Results: The rib fractures were posterolateral (69.6%), lateral (30.4%), upper (4.3%), middle (92.4%), and lower (3.3%). Patients with posterolateral fracture had significantly more complications leading to airway intubation and more intensive care support, higher ISS, associated with pelvic and clavicular fracture. Upper rib fractures were associated with more length-of-stay (LOS) while lower rib fractures were associated more with abdominal trauma and lumbar/thoracolumbar vertebral fractures. A significant positive correlation was seen between the number of fractured ribs and ISS, hospital, and ICU LOS. There were no complications during a two-month follow-up. Conclusions: Upper rib fractures are associated with severe traumas requiring more hospitalization and ICU support due to the greater surgical and medical complications. Morbidity is higher in posterolateral fractures and these patients need more medical care.