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Open Access

Effects of mechanism of injury and patient age on outcomes in geriatric rib fracture patients

Helen H Shi, Micaela Esquivel, Kristan L Staudenmayer, David A Spain
DOI: 10.1136/tsaco-2016-000074 Published 16 March 2017
Helen H Shi
1Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Micaela Esquivel
2Department of Surgery, Stanford University, Stanford, California, USA
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Kristan L Staudenmayer
2Department of Surgery, Stanford University, Stanford, California, USA
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David A Spain
2Department of Surgery, Stanford University, Stanford, California, USA
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    Figure 1

    Number of patients versus age and mechanism. MVC, motor vehicle collisions.

  • Figure 2
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    Figure 2

    Median number of ribs fractured versus age and mechanism. MVC, motor vehicle collisions.

Tables

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  • Table 1

    Patient demographics

    Overall (%)1 Rib fracture2 Rib fractures≥3 Rib fractures
    Sample size97101968
    Age8084.57780
    Gender
     Female53 (55%)6 (60%)8 (42%)39 (57%)
     Male44 (45%)4 (40%)11 (58%)29 (43%)
    ICU disposition28 (29%)0 (0%)3 (16%)25 (37%)
    Non-ICU disposition69 (65%)10 (100%)16 (84%)43 (63%)
     Transfer to ICU6 (6%)0 (0%)2 (11%)4 (6%)
    Cause of injury
     Fall57 (59%)4 (40%)9 (47%)44 (65%)
     MVC32 (33%)3 (30%)8 (42%)21 (31%)
     Other8 (8%)3 (30%)2 (11%)3 (4%)
    Median hospital LOS4334
    Mortality4 (4%)0 (0%)1 (5%)3 (4%)
    • ICU, intensive care unit; LOS, length of stay; MVC, motor vehicle collisions.

  • Table 2

    ED disposition

    VariableOverall (%)ICU—ED disposition (%)Non-ICU—All (%)Non-ICU –transfer to ICU (%)Non-ICU—no transfer to ICU (%)Non-ICU—≥2 rib fractures, no ICU transfer (%)Non-ICU—sent home (%)
    Sample size972869663537
    Age8081.57984.5787780
    Gender
     Female53 (55%)15 (54%)38 (55%)2 (33%)36 (57%)30 (57%)3 (43%)
     Male44 (45%)13 (46%)31 (45%)4 (66%)27 (43%)23 (43%)4 (57%)
    Median ribs fractured3.5534333
    Median ICU LOS0202000
    Median hospital LOS44.536.5331
    Mortality4 (4%)2 (7%)2 (3%)2 (33%)0 (0%)0 (0%)0 (0%)
    • ED, emergency department; ICU, intensive care unit; LOS, length of stay.

  • Table 3

    Mechanism of injury

    MechanismSample size (% of total)Median hospital LOSMortality (%)ICU (%)Non-ICU (%)Transfer to ICU (%)≥2 Rib fractures (%)
    Fall57 (59%)43 (5%)17 (30%)40 (70%)4 (7%)53 (93%)
    MVC32 (33%)31 (3%)9 (28%)23 (72%)2 (6%)29 (91%)
    Other8 (8%)3.50 (0%)2 (25%)6 (75%)0 (0%)5 (63%)
    Bicycle4 (4%)30 (0%)2 (50%)2 (2%)0 (0%)3 (75%)
    Pedestrian2 (2%)50 (0%)0 (0%)2 (100%)0 (0%)1 (50%)
    Assault1 (1%)30 (0%)0 (0%)1 (100%)0 (0%)0 (0%)
    Motorcycle collisions1 (1%)70 (0%)0 (0%)1 (100%)0 (0%)1 (100%)
    • ICU, intensive care unit; LOS, length of stay; MVC, motor vehicle collisions.

  • Table 4

    Age groups

    Age (years)Sample size (% of total)Median hospital LOSMortality (%)ICU (%)Non-ICU (%)Transfer to ICU (%)≥2 Rib fractures (%)
    65–6914 (14%)20 (0%)1 (7%)13 (93%)013 (93%)
    70–7416 (16%)40 (0%)7 (44%)9 (56%)2 (13%)14 (88%)
    75–7918 (19%)41 (6%)5 (28%)13 (72%)017 (94%)
    80–8414 (14%)30 (0%)5 (36%)9 (64%)1 (7%)13 (68%)
    85–8919 (20%)31 (5%)6 (32%)13 (68%)1 (5%)15 (79%)
    90–9413 (13%)42 (15%)3 (23%)10 (77%)2 (15%)12 (92%)
    95–993 (3%)40 (0%)1 (33%)2 (67%)03 (100%)
    • ICU, intensive care unit; LOS, length of stay.

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Effects of mechanism of injury and patient age on outcomes in geriatric rib fracture patients
Helen H Shi, Micaela Esquivel, Kristan L Staudenmayer, David A Spain
Trauma Surg Acute Care Open Mar 2017, 2 (1) e000074; DOI: 10.1136/tsaco-2016-000074

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Effects of mechanism of injury and patient age on outcomes in geriatric rib fracture patients
Helen H Shi, Micaela Esquivel, Kristan L Staudenmayer, David A Spain
Trauma Surg Acute Care Open Mar 2017, 2 (1) e000074; DOI: 10.1136/tsaco-2016-000074
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Effects of mechanism of injury and patient age on outcomes in geriatric rib fracture patients
Helen H Shi, Micaela Esquivel, Kristan L Staudenmayer, David A Spain
Trauma Surgery & Acute Care Open Mar 2017, 2 (1) e000074; DOI: 10.1136/tsaco-2016-000074
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