RIB FRACTURES IN MAJOR TRAUMA

Background: To determine the mortality. hospital and intensive care un it (ICU) stay of rib fractures in patients admitted to Victorian hospi tals for more than 1 day. Methods: All patients fitting the entry crit eria for the Victorian Major Trauma Study with fractured ribs were ide ntified between 1 March 1992 and 28 February 1993. Aetiology, age, sex , associated injury and outcome were analysed. Results: Patients with rib fractures had a higher mortality and length of hospital stay, but this was not significantly different from other trauma. A significantl y higher percentage of patients required ICU care for rib fractures (4 4%) compared with the total group with blunt injury (24%), The majorit y 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 fur patients with fractured ribs versus total trauma group was higher in elderly patients, Univariate analysis showed rib fractures were a p ositive predictor of death but when adjusted for ISS and age, rib frac tures became a negative predictor. Rib fractures were not predictors f or length of ICU or hospital stay. Conclusion: The sample of rib fract ures collected in this study underestimates the overall incidence. For those patients admitted to hospital with identified rib fractures, th ere is a trend towards higher mortality and morbidity. However, this a ssociation is better predicted by ISS and age.