Cameron P, Dziukas L, Hadj A, Clark P, Hooper S
Department of Emergency Medicine, Royal Melbourne Hospital, Parkville, Australia.
Aust N Z J Surg. 1996 Aug;66(8):530-4. doi: 10.1111/j.1445-2197.1996.tb00803.x.
To determine the mortality, hospital and intensive care unit (ICU) stay of rib fractures in patients admitted to Victorian hospitals for more than 1 day.
All patients fitting the entry criteria for the Victorian Major Trauma Study with fractured ribs were identified between 1 March 1992 and 28 February 1993. Aetiology, age, sex, associated injury and outcome were analysed.
Patients with rib fractures had a higher mortality and length of hospital stay, but this was not significantly different from other trauma. A significantly higher percentage of patients required ICU care for rib fractures (44%) compared with the total group with blunt injury (24%). The majority of rib fractures resulted from motor vehicle accidents 361/541 (67%). Injuries occurring on the street/highway resulting in rib fractures were more likely to be major; 62% had Injury Severity Score (ISS) > 15. Fractured ribs occurred more commonly with increased age. Mortality for patients with fractured ribs versus total trauma group was higher in elderly patients. Univariate analysis showed rib fractures were a positive predictor of death but when adjusted for ISS and age, rib fractures became a negative predictor. Rib fractures were not predictors for length of ICU or hospital stay.
The sample of rib fractures collected in this study underestimates the overall incidence. For those patients admitted to hospital with identified rib fractures, there is a trend towards higher mortality and morbidity. However, this association is better predicted by ISS and age.
确定入住维多利亚州医院超过1天的肋骨骨折患者的死亡率、住院时间和重症监护病房（ICU）停留时间。
在1992年3月1日至1993年2月28日期间，识别出所有符合维多利亚州重大创伤研究纳入标准且伴有肋骨骨折的患者。对病因、年龄、性别、合并伤和结局进行分析。
肋骨骨折患者的死亡率和住院时间较长，但与其他创伤患者相比无显著差异。与钝性伤患者总数（24%）相比，肋骨骨折患者需要ICU护理的比例显著更高（44%）。大多数肋骨骨折由机动车事故导致，361/541（67%）。发生在街道/公路上导致肋骨骨折的损伤更可能较为严重；62%的患者损伤严重程度评分（ISS）>15。肋骨骨折随年龄增长更为常见。老年患者中，肋骨骨折患者的死亡率高于总体创伤组。单因素分析显示肋骨骨折是死亡的阳性预测因素，但在调整ISS和年龄后，肋骨骨折成为阴性预测因素。肋骨骨折不是ICU或住院时间的预测因素。
本研究收集的肋骨骨折样本低估了总体发病率。对于那些因肋骨骨折入院的患者，存在死亡率和发病率较高的趋势。然而，这种关联可通过ISS和年龄更好地预测。
