Chen Szu-An, Liao Chien-An, Kuo Ling-Wei, Hsu Chih-Po, Ouyang Chun-Hsiang, Cheng Chi-Tung
Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou, Chang Gung University, Taoyuan 333, Taiwan.
J Pers Med. 2022 Sep 23;12(10):1567. doi: 10.3390/jpm12101567.
Rib fractures (RF) are a common injury that cause significant morbidity and mortality, especially in geriatric patients. RF fixation could shorten hospital stay and improve survival. The aim of this retrospective study was to evaluate the clinical impact and proper surgical timing of RF fixation in geriatric patients. We reviewed all the medical data of patients older than 16 years old with RF from the trauma registry database between January 2017 and December 2019 in Chang Gung Memorial Hospital. A total of 1078 patients with RF were enrolled, and 87 patients received RF fixation. The geriatric patients had a higher chest abbreviated injury scale than the non-geriatric group ( = 0.037). Univariate analysis showed that the RF fixation complication rates were significantly related to the injury severity scores (Odds ratio 1.10, 95% CI 1.03-1.20, = 0.009) but not associated with age (OR 0.99, 95% CI 0.25-3.33, = 0.988) or the surgical timing (OR 2.94, 95% CI 0.77-12.68, = 0.122). Multivariate analysis proved that only bilateral RF was an independent risk factor of complications (OR 6.60, 95% CI 1.38-35.54, = 0.02). RF fixation can be postponed for geriatric patients after they are stabilized and other lethal traumatic injuries are managed as a priority.
肋骨骨折（RF）是一种常见损伤，会导致严重的发病率和死亡率，在老年患者中尤为如此。肋骨骨折固定术可缩短住院时间并提高生存率。这项回顾性研究的目的是评估老年患者肋骨骨折固定术的临床影响和合适的手术时机。我们回顾了2017年1月至2019年12月在长庚纪念医院创伤登记数据库中年龄大于16岁的肋骨骨折患者的所有医疗数据。共有1078例肋骨骨折患者入组，其中87例接受了肋骨骨折固定术。老年患者的胸部简明损伤量表评分高于非老年组（P = 0.037）。单因素分析显示，肋骨骨折固定术的并发症发生率与损伤严重程度评分显著相关（比值比1.10，95%可信区间1.03 - 1.20，P = 0.009），但与年龄（比值比0.99，95%可信区间0.25 - 3.33，P = 0.988）或手术时机（比值比2.94，95%可信区间0.77 - 12.68，P = 0.122）无关。多因素分析证明，只有双侧肋骨骨折是并发症的独立危险因素（比值比6.60，95%可信区间1.38 - 35.54，P = 0.02）。对于老年患者，在病情稳定且优先处理其他致命性创伤后，肋骨骨折固定术可以推迟进行。
