Management of Rib fractures across Non-trauma and Level I, I
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According to this study, nearly half of US adults with traumatic rib fractures present to non-trauma centers. Higher capacity centers had a stepwise increase in admitting high-risk patients and surgically stabilizing the flail chest.

The study by The American Journal of Surgery aimed to elucidate management patterns and outcomes of high-risk patients with rib fractures (elderly or flail chest) across non-trauma and trauma centers. Researchers hypothesized highest-capacity (level I) centers would have the best outcomes for high-risk patients.

Investigators queried the 2016 National Emergency Department Sample to identify adults presenting with rib fractures. Multivariable regression assessed ED and inpatient events across non-trauma and level III/II/I trauma centers.

The study result was;
--Among 504,085 rib fracture encounters, 46% presented to non-trauma centers.

--Elderly patients with multiple rib fractures had a stepwise increase in inpatient admission odds and a stepwise decrease in pneumonia odds at higher-capacity trauma centers compared to non-trauma centers.

--Among patients with flail chest, odds of undergoing surgical stabilization (SSRF) increased at trauma centers. Undergoing SSRF was associated with reduced mortality but remained underutilized.

Overall, half of the patients with rib fractures present to non-trauma centers. Nationwide care-optimization for high-risk patients requires further effort.

Source: https://doi.org/10.1016/j.amjsurg.2021.02.013
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