Division of Trauma, Critical Care, & Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
Division of Trauma, Critical Care, & Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
Am J Surg. 2014 May;207(5):659-62; discussion 662-3. doi: 10.1016/j.amjsurg.2013.12.012. Epub 2014 Jan 31.
The contribution of rib fractures to chronic pain and disability is not well described.
Two hundred three patients with rib fractures were followed for 6 months. Chronic pain was assessed using the McGill Pain Questionnaire Pain Rating Index and Present Pain Intensity (PPI) scales. Disability was defined as a decrease in work or functional status.
The prevalence of chronic pain was 22% and disability was 53%. Acute PPI predicted chronic pain. Associated injuries, bilateral rib fractures, injury severity score, and number of rib fractures were not predictive of chronic pain. No acute injury characteristics were predictive of disability. Among 89 patients with isolated rib fractures, the prevalence of chronic pain was 28% and of disability was 40%. No injury characteristics predicted chronic pain. Bilateral rib fractures and acute PPI predicted disability.
The contribution of rib fractures to chronic pain and disability is significant but unpredictable with conventional injury descriptors.
肋骨骨折对慢性疼痛和残疾的影响尚未得到充分描述。
203 例肋骨骨折患者接受了为期 6 个月的随访。采用麦吉尔疼痛问卷疼痛评分指数和现有疼痛强度(PPI)量表评估慢性疼痛。残疾定义为工作或功能状态下降。
慢性疼痛的患病率为 22%,残疾的患病率为 53%。急性 PPI 可预测慢性疼痛。其他合并损伤、双侧肋骨骨折、损伤严重程度评分和肋骨骨折数量与慢性疼痛无相关性。急性损伤特征与残疾均无相关性。在 89 例单纯肋骨骨折患者中,慢性疼痛的患病率为 28%,残疾的患病率为 40%。无损伤特征可预测慢性疼痛。双侧肋骨骨折和急性 PPI 可预测残疾。
肋骨骨折对慢性疼痛和残疾的影响显著,但用常规损伤指标难以预测。