National utilization of rib fracture fixation in the geriatric population in the United States
Purpose The use of surgical stabilization of rib fractures (SSRF) has steadily increased over the past decade. Recent literature suggests that a larger population may benefit from SSRF, and that the geriatric population—as the highest-risk population—may receive the greatest improvement from these i...
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Korean Society of Traumatology
2022-09-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://jtraumainj.org/upload/pdf/jti-2021-0076.pdf |
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| author | Jennifer M. Brewer Leah Aakjar Kelsey Sullivan Vijay Jayaraman Manuel Moutinho Elan Jeremitsky Andrew R. Doben |
| author_facet | Jennifer M. Brewer Leah Aakjar Kelsey Sullivan Vijay Jayaraman Manuel Moutinho Elan Jeremitsky Andrew R. Doben |
| author_sort | Jennifer M. Brewer |
| collection | DOAJ |
| description | Purpose The use of surgical stabilization of rib fractures (SSRF) has steadily increased over the past decade. Recent literature suggests that a larger population may benefit from SSRF, and that the geriatric population—as the highest-risk population—may receive the greatest improvement from these interventions. We sought to determine the overall utilization of SSRF in the United States. Methods The National Trauma Database was analyzed between 2016 and 2017. The inclusion criteria were all patients ≥65 years old with rib fractures. We further stratified these patients according to age (65–79 vs. ≥80 years old), the presence of coding for flail chest, three or more rib fractures, and intervention (surgical vs. nonoperative management). The main outcomes were surgical interventions, mortality, pneumonia, length of stay, intensive care unit length of stay, ventilator use, and tracheostomy. Results Overall, 93,638 patients were identified. SSRF was performed in 992 patients. Patients who underwent SSRF had improved mortality in the 65 to 79 age group, regardless of the number of ribs fractured. We identified 92,637 patients in the age group of 65 to 79 years old who did not undergo SSRF. This represents an additional 20,000 patients annually who may benefit from SSRF. Conclusions By conservative standards and the well-established Eastern Association for the Surgery of Trauma clinical practice guidelines, SSRF is underutilized. Our data suggest that SSRF may be very beneficial for the geriatric population, specifically those aged 65 to 79 years with any rib fractures. We hypothesize that roughly 20,000 additional cases will meet the inclusion criteria for SSRF each year. It is therefore imperative that we train acute care surgeons in this skill set. |
| format | Article |
| id | doaj-art-f7ca6a4f549549e1884735d8c049f379 |
| institution | Kabale University |
| issn | 2799-4317 2287-1683 |
| language | English |
| publishDate | 2022-09-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-f7ca6a4f549549e1884735d8c049f3792025-01-16T04:54:41ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832022-09-0135317318010.20408/jti.2021.00761117National utilization of rib fracture fixation in the geriatric population in the United StatesJennifer M. Brewer0Leah Aakjar1Kelsey Sullivan2Vijay Jayaraman3Manuel Moutinho4Elan Jeremitsky5Andrew R. Doben6 Department of General Surgery, University of Connecticut School of Medicine, Farmington, CT, USA Department of General Surgery, University of Connecticut School of Medicine, Farmington, CT, USA Department of General Surgery, University of Connecticut School of Medicine, Farmington, CT, USA Division of Trauma and Acute Care Surgery, St. Francis Medical Center, Hartford, CT, USA Division of Trauma and Acute Care Surgery, St. Francis Medical Center, Hartford, CT, USA Division of Trauma and Acute Care Surgery, Baystate Medical Center, Springfield, MA, USA Division of Trauma and Acute Care Surgery, St. Francis Medical Center, Hartford, CT, USAPurpose The use of surgical stabilization of rib fractures (SSRF) has steadily increased over the past decade. Recent literature suggests that a larger population may benefit from SSRF, and that the geriatric population—as the highest-risk population—may receive the greatest improvement from these interventions. We sought to determine the overall utilization of SSRF in the United States. Methods The National Trauma Database was analyzed between 2016 and 2017. The inclusion criteria were all patients ≥65 years old with rib fractures. We further stratified these patients according to age (65–79 vs. ≥80 years old), the presence of coding for flail chest, three or more rib fractures, and intervention (surgical vs. nonoperative management). The main outcomes were surgical interventions, mortality, pneumonia, length of stay, intensive care unit length of stay, ventilator use, and tracheostomy. Results Overall, 93,638 patients were identified. SSRF was performed in 992 patients. Patients who underwent SSRF had improved mortality in the 65 to 79 age group, regardless of the number of ribs fractured. We identified 92,637 patients in the age group of 65 to 79 years old who did not undergo SSRF. This represents an additional 20,000 patients annually who may benefit from SSRF. Conclusions By conservative standards and the well-established Eastern Association for the Surgery of Trauma clinical practice guidelines, SSRF is underutilized. Our data suggest that SSRF may be very beneficial for the geriatric population, specifically those aged 65 to 79 years with any rib fractures. We hypothesize that roughly 20,000 additional cases will meet the inclusion criteria for SSRF each year. It is therefore imperative that we train acute care surgeons in this skill set.http://jtraumainj.org/upload/pdf/jti-2021-0076.pdfgeriatric traumarib fracturessurgical stabilization of rib fracturesrib fixationblunt trauma |
| spellingShingle | Jennifer M. Brewer Leah Aakjar Kelsey Sullivan Vijay Jayaraman Manuel Moutinho Elan Jeremitsky Andrew R. Doben National utilization of rib fracture fixation in the geriatric population in the United States Journal of Trauma and Injury geriatric trauma rib fractures surgical stabilization of rib fractures rib fixation blunt trauma |
| title | National utilization of rib fracture fixation in the geriatric population in the United States |
| title_full | National utilization of rib fracture fixation in the geriatric population in the United States |
| title_fullStr | National utilization of rib fracture fixation in the geriatric population in the United States |
| title_full_unstemmed | National utilization of rib fracture fixation in the geriatric population in the United States |
| title_short | National utilization of rib fracture fixation in the geriatric population in the United States |
| title_sort | national utilization of rib fracture fixation in the geriatric population in the united states |
| topic | geriatric trauma rib fractures surgical stabilization of rib fractures rib fixation blunt trauma |
| url | http://jtraumainj.org/upload/pdf/jti-2021-0076.pdf |
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