Risk Factors for Dyspnea in Rib Fracture Patients: A Prospective Study of Patient-Reported Outcomes.

INTRODUCTION

Rib fractures are common and associated with significant morbidity and mortality. Despite treatment advances, knowledge gaps persist regarding optimization of rib fracture outcomes, particularly for symptoms such as dyspnea post discharge. This study examined the frequency and severity of dyspnea-related patient-reported outcome measures (PROMs) in rib fracture patients.

METHODS

From 2021 to 2022, patients presenting with rib fractures at a Midwest health system used a mobile platform to track PROMs after discharge. Our primary outcome was early dyspnea, defined as dyspnea symptoms within 2 wk (d 4-14) post discharge. We categorized dyspnea as none/mild (scores <4) or moderate/severe (scores ≥4). Multivariable logistic regressions were developed to assess factors associated with more severe dyspnea.

RESULTS

Of the 1103 rib fracture patients during our study period, dyspnea-related PROMs were collected on 98 patients within 2 wk post discharge. Of these respondents, 41.8% reported experiencing moderate/severe early dyspnea. Multivariable logistic regression showed that older age (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.94-0.99; P = 0.048) was associated with lower odds for moderate/severe early dyspnea at 2 wk post discharge, while the need for opioid pain management on admission (OR, 3.8; 95% CI, 1.3-10.5; P = 0.01) and medical history of asthma (OR, 5.7; 95% CI, 1.4-22.2; P = 0.01) were associated with significantly increased odds of moderate/severe early dyspnea.

CONCLUSIONS

We demonstrate the utility and feasibility of remote patient monitoring for characterizing and monitoring post discharge dyspnea symptoms using PROMs. Notably, risk factors such as age, opioid pain management on admission, and asthma history influence the severity of early dyspnea in rib fracture patients. These findings highlight the potential value of utilizing PROMs to help evaluate optimal post discharge follow-up for rib fracture patients.