Department of Thoracic Surgery, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan.
Department of Life Science & Institute of Molecular and Cellular Biology, National Tsing Hua University, Hsinchu, Taiwan.
PLoS One. 2024 Feb 29;19(2):e0299256. doi: 10.1371/journal.pone.0299256. eCollection 2024.
Obesity is a global health issue with increasing prevalence. Surgical procedures, such as surgical stabilization of rib fractures (SSRF), may be affected by obesity-related complications. The objective of the study is to investigate the effects of obesity on SSRF outcomes in multiple rib fractures.
This retrospective study analyzed data from adults aged ≥ 20 years in the Nationwide Inpatient Sample (NIS) database diagnosed with multiple rib fractures who underwent SSRF between 2005 and 2018. It investigated the relationship between obesity and in-patient outcomes, such as discharge status, length of stay (LOS), in-hospital mortality, hospital costs, and adverse events using logistic and linear regression analyses.
Analysis of data from 1,754 patients (morbidly obese: 87; obese: 106; normal weight: 1,561) revealed that morbid obesity was associated with longer LOS (aBeta = 0.07, 95% CI: 0.06, 0.07), higher hospital costs (aBeta = 47.35, 95% CI: 38.55, 56.14), increased risks of adverse events (aOR = 1.63, 95% CI: 1.02, 2.61), hemorrhage/need for transfusion (aOR = 1.77, 95% CI: 1.12, 2.79) and mechanical ventilation ≥ 96 hours (aOR = 2.14, 95% CI: 1.28, 3.58) compared to normal weight patients. Among patients with flail chest, morbid obesity was significantly associated with tracheostomy (aOR = 2.13, 95% CI: 1.05, 4.32), ARDS/respiratory failure (aOR = 2.01, 95% CI: 1.09, 3.70), and mechanical ventilation ≥ 96 hours (aOR = 2.80, 95% CI: 1.47, 5.32). In contrast, morbid obesity had no significant associations with these adverse respiratory outcomes among patients without a flail chest (p > 0.05).
Morbid obesity is associated with adverse outcomes following SSRF for multiple rib fractures, especially for flail chest patients.
肥胖是一个全球性的健康问题，其患病率不断上升。手术治疗，如外科肋骨骨折稳定术（Surgical Stabilization of Rib Fractures，SSRF），可能会受到肥胖相关并发症的影响。本研究的目的是探讨肥胖对多发性肋骨骨折 SSRF 结局的影响。
这是一项回顾性研究，分析了 2005 年至 2018 年期间在全国住院患者样本（Nationwide Inpatient Sample，NIS）数据库中接受 SSRF 治疗的年龄≥20 岁的成人多发性肋骨骨折患者的数据。使用逻辑回归和线性回归分析探讨了肥胖与住院结局（如出院状态、住院时间（Length of Stay，LOS）、院内死亡率、住院费用和不良事件）之间的关系。
对 1754 名患者（病态肥胖：87 例；肥胖：106 例；正常体重：1561 例）的数据进行分析，结果显示病态肥胖与 LOS 延长（aBeta = 0.07，95%置信区间：0.06，0.07）、住院费用增加（aBeta = 47.35，95%置信区间：38.55，56.14）、不良事件风险增加（aOR = 1.63，95%置信区间：1.02，2.61）、出血/需要输血（aOR = 1.77，95%置信区间：1.12，2.79）和机械通气≥96 小时（aOR = 2.14，95%置信区间：1.28，3.58）有关，与正常体重患者相比。在连枷胸患者中，病态肥胖与气管切开术（aOR = 2.13，95%置信区间：1.05，4.32）、急性呼吸窘迫综合征/呼吸衰竭（aOR = 2.01，95%置信区间：1.09，3.70）和机械通气≥96 小时（aOR = 2.80，95%置信区间：1.47，5.32）显著相关。相反，病态肥胖与无连枷胸患者的这些不良呼吸结局无显著相关性（p > 0.05）。
病态肥胖与多发性肋骨骨折 SSRF 后的不良结局相关，尤其是对连枷胸患者。
