Abdulrahman H, Afifi I, El-Menyar A, Al-Hassani A, Almadani A, Al-Thani H, Latifi R
Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.
Clinical Research, Section of Trauma Surgery, Hamad General Hospital, Doha, Qatar.
Eur J Trauma Emerg Surg. 2013 Dec;39(6):605-11. doi: 10.1007/s00068-013-0291-5. Epub 2013 Apr 23.
To evaluate the clinical outcomes of multiple rib fracture due to blunt trauma in young patients, a 3-year retrospective study was conducted. Patients with ≥3 rib fractures were divided into two groups (group I: <45 years old and group II: ≥45 years old). Mortality, hospital stay, ventilatory support, chest tubes insertion and associated injuries were studied.
Of the 902 patients admitted with blunt chest trauma, 240 (27 %) met the inclusion criteria and 72.5 % patients were <45 years old. The most common causes of injury were motor vehicle crash (59 %) and fall (29 %). The Injury Severity Score (ISS) was higher in group I (16 ± 9 vs. 13 ± 6; p = 0.04). Hospital mortality was higher in group II (6 vs. 2 %; p = 0.18). Pneumothorax, haemothorax and ventilatory support were comparable. Patients in group II were more likely to undergo chest tubes insertion (26 vs. 14 %; p = 0.04), while group I had a significantly higher incidence of associated abdominal injuries (25 vs. 12 %; p = 0.03).
Old age presenting with rib fractures is associated with higher mortality in comparison to young age; however, this difference becomes statistically insignificant in the presence of multiple rib fracture.
为评估年轻患者钝性创伤所致多发性肋骨骨折的临床结局,进行了一项为期3年的回顾性研究。将肋骨骨折≥3根的患者分为两组(I组:年龄<45岁;II组:年龄≥45岁)。对死亡率、住院时间、通气支持、胸腔闭式引流管置入情况及相关损伤进行了研究。
在902例因钝性胸部创伤入院的患者中,240例(27%)符合纳入标准,72.5%的患者年龄<45岁。最常见的致伤原因是机动车碰撞(59%)和跌倒(29%)。I组的损伤严重程度评分(ISS)更高(16±9 vs. 13±6;p = 0.04)。II组的医院死亡率更高(6% vs. 2%;p = 0.18)。气胸、血胸和通气支持情况相当。II组患者更有可能接受胸腔闭式引流管置入(26% vs. 14%;p = 0.04),而I组相关腹部损伤的发生率显著更高(25% vs. 12%;p = 0.03)。
与年轻患者相比,肋骨骨折的老年患者死亡率更高;然而,在多发性肋骨骨折的情况下,这种差异在统计学上无显著意义。