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Outcomes of Surgical Stabilization of Rib Fractures in a Minority Population: Retrospective Analysis of a Case Series from an Acute Care Facility

Open AccessPublished:March 10, 2023DOI:https://doi.org/10.1016/j.xjon.2023.03.002
Outcomes of Surgical Stabilization of Rib Fractures in a Minority Population: Retrospective Analysis of a Case Series from an Acute Care Facility
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      Abstract

      Objective

      The aim of was to examine the post-operative outcomes and associated factors of SSRF in a minority population.

      Methods

      A retrospective analysis with case series of 10 patients undergoing SSRF at an acute care facility in New York City was performed. Data including patient demographics, comorbidities, hospital length of stay, and others were collected. Results were presented in comparative tables and a Kaplan Meier curve. Primary outcome was to compare outcomes of SSRF in minority patients to larger studies in non-minority populations. Secondary outcomes included various post-operative outcomes including atelectasis, pain and infection, and the impact of medical comorbidities on each.

      Results

      The median time (with accompanying IQR) from diagnosis to SSRF, SSRF to discharge and overall length of stay was 4.5 (4.25), 6.0 (17.00) and 10.5 (18.25) days respectively. The time until SSRF and post-operative complication rate were found to be comparable to those in larger studies. Kaplan-Meier curve demonstrates correlation between persistence of atelectasis to increased length of stay (p = 0.05). Increased time to SSRF was seen in elderly and diabetic patients (p = 0.012; p = 0.019), increased pain requirements by diabetic patients (p = 0.007) and higher infectious complications noted in flail chest and diabetic patients (p = 0.035; p = 0.002) were also seen.

      Conclusions

      Preliminary outcomes and complication rates of SSRF in a minority population are shown to be comparable to larger studies in non-minority populations. Larger, higher-powered studies are required to further compare outcomes between these two populations.

      Graphical abstract

      Figure thumbnail fx1
      Graphical Abstract

      Glossary of Abbreviations:

      SSRF (surgical stabilization of rib fracture), HLOS (Hospital Length of stay), IRB (Institutional Review Board), LOS (length of stay), IQR (interquartile range), SD (Standard deviation), PO (per oral), ICU (intensive care unit), TQIP (Trauma Quality Improvement Program), BMI (body mass index), EAST (Eastern Association for the Surgery of Trauma), PRN (pro re nata), ERAS (Enhanced Recovery After Surgery), MV (motor vehicle), MVA (motor vehicle accident), VATS (video-assisted thoracic surgery), PLT (posterolateral thoracotomy), ALT (anterolateral thoracotomy), SNF (skilled nursing facility)

      Article info

      Publication history

      Accepted: March 2, 2023
      Received: October 27, 2022

      Publication stage

      In Press Journal Pre-Proof

      Footnotes

      Manuscript was written by MMR and SV, Data collection by IM; Data analysis by BA reviewed and edited by AS

      The Institutional Review Board (IRB) or equivalent ethics committee of the Harlem Hospital Center approved the study protocol and publication of data. Patient written consent for the publication of the study data was waived by the IRB as data was collected by retrospective review of documentation within respective medical records only

      IRB Approval Number: BRANY IRB File # 22-12-704-273(HHC)

      The authors have no competing interests.

      No funding was provided.

      Central Message

      Rib fractures are associated with increased morbidity. Minority populations and those with limited insurance are less frequent recipients of surgical stabilization which further increases morbidity.

      Perspective Statement

      Minority populations are less frequent recipients of surgical stabilization of rib fractures and are also grossly understudied with a significant deficit in available literature. We examined postoperative outcomes of surgical stabilization of rib fractures in a minority population, and our results demonstrate outcomes and complication rate comparable to larger studies in non-minority populations.

      Clinical Picture Legend: none

      Identification

      DOI: https://doi.org/10.1016/j.xjon.2023.03.002

      Copyright

      © 2023 The Authors. Published by Elsevier Inc. on behalf of The American Association for Thoracic Surgery

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