دورية أكاديمية
In- and out-of-hospital outcomes following surgical stabilization of rib fractures in 80 years and older: A single-institution experience.
| العنوان: | In- and out-of-hospital outcomes following surgical stabilization of rib fractures in 80 years and older: A single-institution experience. |
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| المؤلفون: | Varre JSV; Ohio Health Riverside Methodist Hospital, 3535 Olentangy River Road Columbus, Ohio 43214, USA. Electronic address: jayasvarre@gmail.com., Hopmann P; Ohio Health Riverside Methodist Hospital, 3535 Olentangy River Road Columbus, Ohio 43214, USA., Wu JL; Ohio Health Riverside Methodist Hospital, 3535 Olentangy River Road Columbus, Ohio 43214, USA., Bach JA; Ohio Health Riverside Methodist Hospital, 3535 Olentangy River Road Columbus, Ohio 43214, USA., Suh KI; Ohio Health Riverside Methodist Hospital, 3535 Olentangy River Road Columbus, Ohio 43214, USA., Goslin BJ; Ohio Health Riverside Methodist Hospital, 3535 Olentangy River Road Columbus, Ohio 43214, USA., DeVoe WB; Ohio Health Riverside Methodist Hospital, 3535 Olentangy River Road Columbus, Ohio 43214, USA. |
| المصدر: | Injury [Injury] 2023 Sep; Vol. 54 (9), pp. 110871. Date of Electronic Publication: 2023 Jun 04. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 0226040 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0267 (Electronic) Linking ISSN: 00201383 NLM ISO Abbreviation: Injury Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2002->: Amsterdam : Elsevier Original Publication: Bristol, Wright. |
| مواضيع طبية MeSH: | Flail Chest*/surgery , Rib Fractures*/surgery , Rib Fractures*/complications , Thoracic Injuries*/complications, Aged, 80 and over ; Humans ; Hospitals ; Length of Stay ; Retrospective Studies ; Ribs ; Treatment Outcome |
| مستخلص: | Background: Surgical stabilization of rib fractures (SSRF) has demonstrated benefit in patients with flail chest and multiple displaced fractures. There is mounting evidence for SSRF following chest wall injury (CWI) for the geriatric trauma population. A recent multi-center retrospective study highlighted a mortality benefit even for those patients aged 80 years and older. The objective of this investigation was to review our institutional experience with both in- and out-of-hospital outcomes within this patient population following SSRF. Methods: A retrospective review of patients 80 years and older was performed at a high-volume level 2 trauma center from 2017 to 2021. SSRF volume is routinely >60 cases per year. Perioperative, inpatient, and outpatient data were collected as available. Primary outcomes were inpatient and 90-day mortality. Secondary outcomes included discharge on narcotics and freedom from narcotics at 30 days. Results: 50 patients were included for review. Mean age was 86 years and mechanism of injury was most often fall. 28 of 50 (56%) patients had flail chest (radiographic). Mean number of ribs fixated was 4.7 and time to surgery 2.5 days. Inpatient mortality was 3/50 (6%), 90-day mortality was 9/50 (18%) of which three were attributable primarily to CWI (6/50, 12%). Of patients with follow-up of 1 year and beyond, 27/28 were alive (96%). With respect to narcotic consumption, 45% (21/47) were discharged on narcotics with 90% (28/31; N limited by missing data) being narcotic-free at 30 days. Conclusion: In this high-risk patient population, inpatient mortality was comparably low to prior reports, though 90-day mortality was doubled when incorporating CWI-related deaths. Narcotic use was seen in the minority of patients upon discharge, and most progressed to being narcotic-free at 30 days post-hospitalization. Inpatient outcomes alone may not adequately define both the benefit and risk of SSRF performed in patients 80 years and older. Competing Interests: Declaration of Competing Interest No funding was received for this study. All co-authors have seen and agree with the contents of the manuscript. WBD is a consultant for Acute Innovations/AcuMed. All other authors have no disclosures. (Copyright © 2023 Elsevier Ltd. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Blunt trauma; Octogenarian; Surgical stabilization of rib fractures |
| تواريخ الأحداث: | Date Created: 20230623 Date Completed: 20230814 Latest Revision: 20230814 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.injury.2023.110871 |
| PMID: | 37353448 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1879-0267 |
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| DOI: | 10.1016/j.injury.2023.110871 |