Early versus late surgical stabilization of severe rib fractures in patients with respiratory failure: A retrospective study
Journal
PLoS ONE
Journal Volume
14
Journal Issue
4
Date Issued
2019
Author(s)
Abstract
Introduction The timing of surgical stabilization of rib fractures remains controversial. We hypothesized that early surgical stabilization (within 3 days of injury) can improve clinical outcome in patients with severe rib fractures and respiratory failure. The aim of this study was to analyze the impact of early surgical stabilization of rib fractures on the perioperative results, clinical outcomes, and medical costs of patients with severe rib fractures and respiratory failure. Methods This was a retrospective comparative study based on a prospectively collected database at a single institute. Patients with severe rib fractures and respiratory failure who underwent surgical stabilization were classified into early (within 3 days of injury) and late (more than 3 days after injury) groups. Outcome measures included operation time, duration of mechanical ventilation, intensive care unit stay, hospital stay, complication rate, mortality rate, and medical cost. Results A total of 33 patients were enrolled (16 and 17 in the early and late groups, respectively). The demographics, trauma mechanism, associated injuries, and severity of trauma were comparable in both groups. The early group had significantly shorter duration of mechanical ventilation (median 36 vs. 90 hours, p = 0.03), intensive care unit stay (median 123 vs. 230 hours, p = 0.004), and hospital stay (median 12 vs. 18 days, p = 0.005); and lower National Health Insurance costs (median 6,617 vs. 10,017 US dollars, p = 0.031). The early group tended to have lower rates of morbidity and mortality, but the difference was not statistically significant. Conclusion Early surgical stabilization of rib fractures in selected patients may significantly shorten their duration of mechanical ventilation, and intensive care unit and hospital stays, while incurring less medical costs. ? 2019 Su et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
SDGs
Other Subjects
adult; aged; Article; artificial ventilation; clinical article; clinical outcome; comparative study; demography; disease activity; disease association; disease duration; disease severity; early intervention; female; health care cost; hospitalization; human; intensive care unit; length of stay; male; morbidity; mortality rate; national health insurance; operation duration; orthopedic surgery; outcome assessment; perioperative period; postoperative complication; respiratory failure; retrospective study; rib fracture; surgical stabilization; therapy delay; traumatology; treatment duration; complication; economics; middle aged; respiratory failure; rib fracture; very elderly; young adult; Adult; Aged; Aged, 80 and over; Humans; Middle Aged; Operative Time; Respiratory Insufficiency; Retrospective Studies; Rib Fractures; Young Adult
Publisher
Public Library of Science
Type
journal article