Highlights
- •Patients with rib fractures managed with SSRF have similar rates of readmissions and complications of non-operatively managed patients.
- •Surgical stabilization of rib fractures (SSRF) utilization varies widely across institutions.
- •Predictor for risk of SSRF was admission to hospital considered high volume center for rib fixation.
Abstract
Introduction
There has been increasing use of surgical stabilization of rib fractures (SSRF), but
most literature demonstrate outcomes of single centers during the index hospitalization.
We sought to analyze statewide patterns and longer-term outcomes after SSRF.
Methods
Adult patients with >1 rib fracture in the 2016–2018 California Office of Statewide
Health Planning Database were identified. SSRF and non-operatively managed (NO) patients
were matched on clinical and demographic variables. Patterns and outcomes of SSRF
were assessed with multivariate modeling.
Results
599 SSRF patients were matched to 1191 NO patients. Readmission and readmission complication
rates were similar between the groups. In a competing risks regression, admission
to a high-volume SSRF center (SHR 4.6, CI95 4.0–5.4, p = 0.01) was the primary predictor
of SSRF. 30-day mortality adjusted risk was lower for the SSRF vs. NO group (HR 0.47,
CI 0.25–0.88, p = 0.02).
Discussion
Statewide utilization of SSRF varied widely and appears to be driven by center or
surgeon characteristics rather than clinical factors. Efforts to expand access to
SSRF based on clinical factors may be warranted.
Keywords
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Article info
Publication history
Published online: April 07, 2022
Accepted:
April 4,
2022
Received in revised form:
February 26,
2022
Received:
November 19,
2021
Identification
Copyright
Published by Elsevier Inc.
